摘要
目的探讨血清氨基末端脑钠肽前体(NT-proBNP)及血清可溶性生长刺激表达基因2蛋白(sST2)对接受规范治疗的慢性心力衰竭患者死亡风险的预测价值。方法选取自2016年3月至2019年3月于北部战区总医院心血管内科因慢性心力衰竭住院治疗的194例患者为研究对象。所有患者均于入院后完善基线资料,于入院后次日清晨空腹12 h状态下采集静脉血,收集血液样本,测定血清NT-proBNP及sST2浓度。所有患者均接受了指南推荐的标准规范化治疗。患者出院后接受为期1年的门诊或电话远程随访,以全因死亡为主要终点,并根据随访终点将患者分为存活组(n=174)与死亡组(n=20)。采用受试者工作特征(ROC)曲线分析NT-proBNP及sST2对慢性心力衰竭患者出院后1年死亡风险的预测价值。结果死亡组患者的年龄、血清NT-proBNP及sST2水平均高于存活组,差异有统计学意义(P<0.05)。sST2及NT-proBNP水平随着纽约心脏病学会心功能分级的恶化不断升高,且趋势性P<0.01。血清sST2、NT-proBNP在预测慢性心力衰竭患者出院后1年全因死亡发生风险方面效果可靠,曲线下面积分别为0.89、0.68。与NT-proBNP比较,血清sST2对患者出院后1年全因死亡的预测能力价值更高(P<0.05)。结论血清NT-proBNP与sST2水平在预测慢性心力衰竭患者出院后1年发生全因死亡风险方面均可靠,且血清sST2相较于NT-proBNP的预测能力更优。
Objective To investigate the predictive value of serum N-terminal pro-brain natriuretic peptide(NT-proBNP)and soluble suppression of tumorigenicity-2(sST2)protein in predicting mortality risk in patients with chronic heart failure.Methods A total of 194 patients hospitalized for chronic heart failure in the Department of Cardiology,General Hospital of Northern Theater Command from March 2016 to March 2019 were selected as the research objects.The baseline data of all patients were improved after admission.Venous blood samples were collected under fasting 12 hours state the next morning after admission,and serum concentrations of NT-proBNP and sST2 were measured.All patients received standard standardized care as recommended by the guidelines.After discharge,the patients received 1-year outpatient or telephone follow-up.All-cause death was the primary endpoint,and the patients were divided into survival group(n=174)and death group(n=20)according to the follow-up endpoint.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of NT-proBNP and sST2 on the 1-year mortality risk in patients with chronic heart failure after discharge.Results The age,serum NT-proBNP and sST2 levels of the death group were higher than those of the survival group,and the differences were statistically significant(P<0.05).The levels of sST2 and NT-proBNP increased with the deterioration of New York Heart Associat cardiac function classification,and the trend was P<0.01.Serum sST2 and NT-proBNP were reliable in predicting the risk of all-cause death in patients with chronic heart failure at 1 year after discharge,and the areas under the curve were 0.89 and 0.68,respectively.Compared with NT-proBNP,serum sST2 had a higher predictive value for all-cause mortality 1 year after discharge(P<0.05).Conclusion Serum sST2 and NT-proBNP are both reliable in predicting the risk of all-cause mortality in patients with chronic heart failure at 1 year after discharge,and serum sST2 has a better predictive ability than NT-proBNP.
作者
侯智为
那堃
梅竹
闫承慧
于海波
HOU Zhi-wei;NA Kun;MEI Zhu;YAN Cheng-hui;YU Hai-bo(Department of Cardiology,Military Institute of Cardiovascular Diseases,General Hospital of Northern Theater Command,Shenyang 110016,China)
出处
《临床军医杂志》
CAS
2022年第10期1030-1033,1038,共5页
Clinical Journal of Medical Officers
基金
辽宁省科学技术计划项目(2020JH1/10300002)
作者简介
第一作者:侯智为(1991-),男,辽宁鞍山人,主治医师,硕士;通信作者:于海波,E-mail:yuhaibo_74@126.com
