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目的：探讨血浆N 末端B 型利钠肽原(N-terminal pro-B-type natriuretic peptide，NT-proBNP)水平评估心力衰竭(heart failure， HF)患者预后的价值。方法：选择2012 年6 月至2014 年7 月本院住院的心衰患者96 例，在入院第二天常规行心脏彩超及血液生化检查，并测定患者血浆中NT-proBNP 水平。对患者的一般资料、心脏彩超、NT-proBNP 水平及18 个月随访期内心脏不良事件发生率进行分析。按随访期内是否发生心脏不良事件分为事件组与非事件组，根据NT-proBNP 水平高低分为高NT-proBNP 组 (NT-proBNP>3200 pg/mL)和低NT-proBNP组(NT-proBNP≤ 3200 pg/mL)，并对相关数据进行统计学分析。结果：事件组NT-proBNP 水平较非事件组明显增高(P<0.001)。多因素logistic 回归分析显示只有NT-proBNP是预测心脏不良事件发生的独立危险因素。NT-proBNP 水平预测心衰患者18 个月内死亡的ROC 曲线下面积为0.873，以随访患者平均NT-proBNP 水平均数3200 pg/mL 作为分组的界值，通过Kaplan-Meier法作NT-proBNP不同水平患者在随访期间心脏不良事件发生率曲线，计算Log-rank 为29.563(P=0.000)。结论：血浆NT-proBNP 水平是心衰患者发生心脏不良事件的独立危险因素之一，不同NT-proBNP 水平对心衰患者的预后影响不同，超过3200 pg/mL的患者预后较差。

英文摘要:

Objective:To explore the prognostic value of plasma NT-proBNPin patients with heart failure.Methods:Totally 96 patients with heart failure were enrolled in the study. Color echocardiography and blood biochemical examination were performed at second day after admission. Plasma NT-proBNP of patients was measured.The general data, color echocardiography, NT-proBNP and the incidence of adverse cardiac events during 18 months of follow up were analyzed.According to the incidence of adverse cardiac events during the follow up, all patients were divided into event group and non-event group.According to the level of NT-proBNP, all patients were divided into high NT-proBNPgroup (NT-proBNP>3200 pg/mL) and low NT-proBNPgroup (NT-proBNP≤ 3200 pg/mL). The data was analyzed by statistics.Results:Compared with non-event group, NT-proBNP level in event group was increased obviously(P<0.001). Multiple logistic regression analysis showed that only NT-proBNPwas an independent risk factor for adverse cardiac events. The area under ROC curve for predicting cardiac death of heart failure patient within 18 months by NT-proBNPwas 0.873. The mean NT-proBNPwith 3200 pg/mL in patients during follow up was taken as the value for the grouping, then the curve of the incidence of adverse cardiac events of patients with different level of NT-proBNPduring follow up was made by using Kaplan-Meier method, and Log-rank calculated was 29.563 (P =0.0000).Conclusion:NT-proBNP level is an independent risk factor of adverse cardiac events in patients with heart failure. The influence of different level of NT-proBNP on the prognosis of patients with heart failure is different. Patients with NT-proBNP≥ 3200pg/mL have poor prognosis.

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