摘要
目的 探讨血浆致动脉硬化指数(AIP)、超敏C反应蛋白(hs-CRP)、氨基末端脑钠肽前体(NT-proBNP)对急性心肌梗死(AMI)新发心力衰竭(HF)的早期预测价值。方法 选择2019年1月至2022年11月收治的295例AMI患者为研究对象,根据入院后24 h内是否发生HF分为新发HF组(139例)、无HF组(156例)。比较两组AIP、hs-CRP、NT-proBNP及相关指标的差异,探讨AIP、hs-CRP、NT-proBNP与Gensini积分、Killip分级、心功能的相关性,采用多元逐步logistic回归分析影响因素,采用受试者操作特征(ROC)曲线分析预测价值。结果 与无HF组比较,新发HF组的患者年龄更大(P <0.05)、体重指数(BMI)更低(P <0.05)、入院时合并心房颤动比例、心率、血小板计数、肌钙蛋白I、AIP、hs-CRP、NT-proBNP水平更高(P <0.05),血管开通时间更长(P <0.05),血红蛋白水平更低(P <0.05)。AIP、hs-CRP、NT-proBNP与Gensini积分、Killip分级呈正相关,与LVEF负相关(P <0.05)。入院时心率、血管开通时间、AIP、hs-CRP、NT-proBNP是AMI患者新发HF的独立危险因素(P <0.05)。AIP、hs-CRP、NT-proBNP联合预测AMI患者新发HF的曲线下面积为0.870,大于各指标单独预测(Z=2.603、2.816、2.901,P=0.035、0.021、0.007)。结论 AIP、hs-CRP、NT-proBNP与AMI早期心功能下降有一定相关性,对患者新发心力衰竭有早期预测价值。
Objective To investigate the predictive value of atherosclerotic index of plasma(AIP),hypersensitive C-reactive protein(hs-CRP) and N-terminal brain natriuretic peptide precursor(NT-proBNP) in new-onset heart failure(HF) in patients with acute myocardial infarction(AMI).Methods A total of 295 AMI patients admitted to our hospital from January 2019 to November 2022 were selected as the research objects.According to whether HF occurred within 24 hours after admission,they were divided into HF group(n=139) and non-HF group(n=156).The levels of AIP,hs-CRP,NT-proBNP and related indicators were compared between the two groups.The correlations of AIP,hs-CRP,NT-proBNP with Gensini score,Killip grade and cardiac function were discussed.Multiple stepwise logistic regression was used to analyze the influencing factors.Receiver operating characteristic(ROC) curve was used to analyze the predictive value.Results Compared with the non-HF group,the HF group had older age(P<0.05),lower BMI(P<0.05),higher levels of atrial fibrillation,heart rate,platelet count,cardiac troponin I,AIP,hs-CRP and NT-proBNP on admission(P<0.05),longer vascularization time (P <0.05),and lower hemoglobin level(P <0.05).AIP,hs-CRP and NT-proBNP were positively correlated with Gensini score and Killip classification,and negatively correlated with LVEF(P<0.05).Heart rate at admission,vascular opening time,AIP,hs-CRP and NT-proBNP were independent risk factors for new-onset HF in AMI patients(P <0.05).The are under the curve(AUC) of AIP,hs-CRP and NT-proBNP combined in predicting new-onset HF in AMI patients was 0.870,which was larger than that of each index alone(Z=2.603,2.816,2.901,P =0.035,0.021,0.007).Conclusion AIP,hs-CRP and NT-proBNP have certain correlation with the decline of cardiac function in the early stage of AMI,which has early predictive value for new-onset HF in AMI patients.
作者
郑朝霞
牛福英
李晴
罗静慧
李莉
ZHENG Zhaoxia;NIU Fuying;LI Qing;LUO Jinghui;LI Li(Department of Cardiovascular Medicine,Fourth People’s Hospital of Langfang City/Affiliated Hospital of ChengdeMedical College,Langfang 065700,Hebei,China;Ultrasound Diagnosis Department,Fourth People’s Hospital ofLangfang City/Affiliated Hospital of Chengde Medical College,Langfang 065700,Hebei,China;Department of Neurology,Fourth People’s Hospital of Langfang City/Affiliated Hospital of Chengde Medical College,Langfang 065700,Hebei,China)
出处
《中国分子心脏病学杂志》
CAS
2023年第6期5790-5795,共6页
Molecular Cardiology of China
关键词
急性心肌梗死
血浆致动脉硬化指数
超敏C反应蛋白
氨基末端脑钠肽前体
心力衰竭
Acute myocardial infarction
Atherosclerotic index of plasma
Hypersensitive C-reactive protein
N-terminal brain natriuretic peptide precursor
Heart failure
作者简介
通信作者:郑朝霞,Email:buwangchuxin201229@163.com。
