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N末端脑钠尿肽原预测老年人腹部手术后心脏事件的价值 被引量：2

Predictive value of N-terminal pro-brain natriuretic peptide for perioperative major cardiovascular events in elderly patients undergoing abdominal surgery
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摘要 目的:探讨术前血浆N末端脑钠尿肽原(NT-proBNP)水平对老年腹部手术患者围手术期严重心血管事件(PMCE)的预测价值。方法:检测173例拟实施腹部手术老年患者的术前血浆NT-proBNP浓度,通过ROC曲线下面积比较术前血浆NT-proBNP水平和修订心脏风险指数(RCRI)在预测老年腹部手术患者围手术期发生PMCE的价值并找出理想截断点值。结果:围手术期发生PMCE 12例,PMCE组血浆NT-proBNP浓度显著高于无PMCE组,中位数分别为452.6 ng/L和67.1 ng/L,NT-proBNP-log分别为2.72±0.43和1.82±0.39,P<0.01。术前血浆NT-proBNP的ROC曲线下面积为0.964(95%CI 0.924-0.986,P<0.01),RCRI的ROC曲线下面积为0.79(95%CI0.722-0.848,P<0.01),二者的曲线下面积比较相差0.174,P<0.05。NT-proBNP预测围手术期PMCE的截断点为230.2 ng/L,其诊断灵敏度、特异度和准确度分别为92%、96%和96%。结论:术前血浆NT-proBNP能预测老年腹部手术患者PMCE的发生,可以作为术前风险评估的工具。 AIM： To investigate the value of N-terminal pro-brain natriuretic peptide（NT-proBNP） levels in predicting perioperative major cardiovascular events（PMCE） in elderly patients undergoing abdominal surgery.METHODS： NT-proBNP was determined preoperatively in 173 patients undergoing surgery.ROC analyses were performed to evaluate the predictive values of plasma NT-proBNP and revised cardiac risk index（RCRI） for perioperative PMCE in elderly patients undergoing abdominal surgery and to identify the optimal NT-proBNP cut-off for predicting perioperative PMCE.RESULTS： Twelve patients developed perioperative complications of PMCE.Preoperative NT-proBNP levels were significantly higher in patients experiencing cardiac events compared with the levels in patients without events（median 452.6 ng/L vs.67.1 ng/L;NT-proBNP-log 2.72/0.43 vs.1.82/0.39,P0.01）.In a receiver-operator characteristic（ROC） analysis for the prediction of PMCE,the area under ROC curve for NT-proBNP was significantly higher than the area under ROC curve for RCRI（0.964,95% CI 0.924-0.986,P0.01） vs.0.79,95% CI 0.722-0.848,P0.01）（P0.05）.The optimal predictive accuracy was achieved with a NT-proBNP threshold of 230.2 ng/L.CONCLUSION： In elderly patients undergoing abdominal surgery,preoperative NT-proBNP level can predict short-term postoperative PMCE.NT-proBNP is a useful tool in the preoperative evaluation of elderly patients undergoing abdominal surgery.
作者 龚卫琴 高德伟 王蓉 李文兵 卢文宁 刘朝阳 蔡毅
机构地区 解放军总医院南楼临床部外二科
出处 《心脏杂志》 CAS 2011年第6期744-747,共4页 Chinese Heart Journal
关键词 N末端B型钠尿肽原 手术 心脏事件 老年 N-terminal pro-brain natriuretic peptide surgery cardiac events elderly patients
分类号 R572 [医药卫生—消化系统]
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参考文献12

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二级参考文献12

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共引文献4

同被引文献17

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心脏杂志
2011年 第6期

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