| 于洪波,马大实,王宝刚,马春野.心脏瓣膜疾病患者术后危险因素及潜在预测指标初探[J].,2018,(13):2483-2487 |
| 心脏瓣膜疾病患者术后危险因素及潜在预测指标初探 |
| A Preliminary Study on the Risk Factors and Potential Predictors for Patients with Heart Valve Disease |
| 投稿时间：2018-02-02 修订日期：2018-02-24 |
| DOI：10.13241/j.cnki.pmb.2018.13.017 |
| 中文关键词: 心脏瓣膜疾病 心肌肌钙蛋白 血浆氨基末端脑钠肽前体 预后评估 |
| 英文关键词: Heart valve disease Cardiac troponin N-terminal pro-brain natriuretic peptide Prognostic indicators |
| 基金项目:吉林省科技厅科技发展计划项目(20160520148JH)；吉林省卫生厅青年基金项目(2017Q018)；吉林省中医药科技项目(2017244) |
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| 中文摘要: |
| 摘要 目的：评价心肌肌钙蛋白(cardiac troponin，cTnT)、氨基末端脑钠肽前体(N-terminal pro?-brain natriuretic peptide，NT-proBNP)对于心瓣膜疾病手术患者术后并发症的预测价值。方法：选取我院2014年1月～2015年12月收治的心瓣膜病患者共108例，入院即记录其年龄、性别、BMI指数、NYHA等，于患者出院1个月后开始随访，随访时间为18个月，根据随访结局分为预后良好组与预后不良组。生存曲线显示随访后的不良预后率；单因素、多因素Cox回归评价各因素对患者预后情况的影响程度；ROC曲线分析其对疾病预后的预测价值。结果：多因素Cox回归分析显示左心室舒张末期内径(left ventricular end-diastolic dimension，LVEDD)(P=0.022)、cTnT(P=0.023)和NT-proBNP(P=0.016)对患者术后不良预后存在影响，其中，LVEDD的影响程度最高(RR=2.142)，其次为NT-proBNP(RR=2.046)；ROC曲线下NT-proBNP联合cTnT预测的AUC为0.856，其特异性为83.6%，敏感性为79.3%。结论：NT-proBNP联合BNP对心瓣膜置换术后患者的预后有较好的预测价值。 |
| 英文摘要: |
| ABSTRACT Objective: To evaluate the predictive value of cardiac troponin (cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) for postoperative complications in patients with valvular heart disease value. Methods: 108 patients with valvular heart disease in our hospital were enrolled from January 2014 to December 2015. Their age, sex, BMI, and NYHA were recorded. The patients were followed up for 1 month after discharge and the follow-up time for 18 months. According to follow-up outcome, patients were divided into good prognosis group and poor prognosis group. Survival curve was applied to show the adverse prognosis after follow-up. Cox regression was used to evaluate the influence of each factor on the prognosis of patients. The ROC curve was used to predict the prognostic value of the disease. Results: Multivariate Cox regression analysis showed that left ventricular end-diastolic dimension (LVEDD) (P=0.022), cTnT (P=0.023) and NT-proBNP (P=0.016) had an effect on postoperative poor prognosis and LVEDD was the highest (RR=2.142), followed by NT-proBNP (RR=2.046). The AUC of NT-proBNP combined with cTnT under ROC curve was 0.856. its specificity was 83.6%, and the sensitivity was 79.3%. Conclusion: NT-proBNP combined with BNP has a good predictive value in the prognosis of patients after cardiac valve replacement. |
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