摘要
目的分析血浆容量(PV)预测慢性收缩性心力衰竭(SHF)患者短期预后的价值。方法选择慢性SHF患者[左室射血分数(LVEF)<40%]160例为研究对象,根据入院PV[(100-红细胞压积(%)/血红蛋白(g/L)]水平分为Q1组(<3.41)52例、Q2组(≥3.41~<4.38)55例和Q3组(≥4.38)53例,随访记录全因死亡事件。结果Q1组、Q2组、Q3组患者年龄、N末端B型脑利钠肽前体(NT-proBNP)水平、肌酐水平、红细胞压积呈升高趋势,收缩压和舒张压、血红蛋白水平呈降低趋势,组间比较差异均有统计学意义(P<0.05)。随访截至2021年4月,共45例全因死亡(28.1%),其中Q1组7例(13.5%)、Q2组13例(23.6%)和Q3组25例(47.2%),全因死亡率呈逐渐增加趋势,组间比较差异均有统计学意义(P<0.05)。PV和ln(NT-proBNP)升高是全因死亡的独立危险因素(P<0.05)。受试者工作特征(ROC)曲线分析显示,PV、ln(NT-proBNP)以及联合诊断预测全因死亡的曲线下面积(AUC)分别为0.753、0.692和0.841(P<0.05)。结论慢性SHF患者PV升高对预测短期全因死亡有重要的应用价值,有望成为指导临床早期评估患者预后的重要指标。
Objective To analyze the value of plasma volume(PV)in predicting the short-term prognosis of patients with chronic systolic heart failure(SHF).Methods A total of 160 patients with chronic SHF[left ventricular ejection fraction(LVEF)<40%]were selected.According to the admission PV[(100-hematocrit(%)/hemoglobin(g/L)]level,52 patients were in Q1 group(<3.41),55 patients were in Q2 group(≥3.41~<4.38)and 53 patients were in Q3 group(≥4.38).All cause deaths were recorded during follow-up.Results Age,N-terminal B-type brain natriuretic peptide precursor(NT-proBNP)level,creatinine level and hematocrit of patients in the group Q1,group Q2 and group Q3 showed an increasing trend,while systolic and diastolic blood pressure and hemoglobin level showed a decreasing trend,and the differences between groups were statistically significant(P<0.05).Up to April 2021,a total of 45 cases(28.1%)had all-cause death,including 7 cases(13.5%)in group Q1,13 cases(23.6%)in group Q2 and 25 cases(47.2%)in group Q3.The all-cause mortality showed a gradual increase trend,and the differences between groups were statistically significant(P<0.05).Increased PV and In(NT-proBNP)were independent risk factors for all-cause death(P<0.05).The increase of PV and ln(NT-proBNP)were the independent risk factor to all-cause death(P<0.05).Receiver operator characteristic(ROC)curve showed that the area under the curve(AUC)of PV,ln(NT-proBNP)and combined diagnosis for all-cause death were 0.753,0.692 and 0.841(P<0.05),respectively.Conclusion The increase of PV in patients with chronic SHF has important application value in predicting short-term all-cause death,and it is expected to be an important index to guide the early clinical evaluation of patients'prognosis.
作者
汝奎
武冰琳
姚鹏
RU Kui;WU Binglin;YAO Peng(Department of Cardiology,Suzhou First People′s Hospital in Anhui Province,Suzhou,Anhui,234000)
出处
《实用临床医药杂志》
CAS
2021年第18期116-119,132,共5页
Journal of Clinical Medicine in Practice
关键词
收缩性心力衰竭
血浆容量
全因死亡
N末端-脑钠肽前体
systolic heart failure
plasma volume
all-cause death
N-terminal pro-brain natriuretic peptide
