中国全科医学2017，Vol.20Issue(1)：62-66,5.DOI:10.3969/j.issn.1007-9572.2017.01.013
N末端B型利钠肽原联合冠状动脉钙化总积分对老年稳定性冠心病患者预后风险评估的价值研究
Value of N - terminal Pro - B - type Natriuretic Peptide Combined with Total Coronary Calcification Score in Evaluating the Risk of Prognosis among Elderly Patients with Stable Coronary Artery Disease
摘要
Abstract
Objective To investigate the value of N - terminal pro - B - type natriuretic peptide( NT-proBNP) combined with total coronary calcification score( TCS)in evaluating the risk of prognosis among elderly patients with stable coronary artery disease ( SCAD) . Methods A total of 264 elderly patients with SCAD,who were under treatment in Department of Geriatric Cardiology,Provincial Hospital Affiliated to Anhui Medical University from March 2013 to January 2016 were selected in the study. According to whether there were major adverse cardiovascular events(MACE)during the follow - up periold(2 - 34 months)or not,the subjects were classified into non - MACE group(n = 151)and MACE group(n = 113). The German full - automatic immunoassay analyzer(Roche Elecsys 2010)and Roche kit were applied to detect the plasma levels of NT-proBNP;CT scan of coronary artery of the patients was performed by 64 - row with 128 - slice computed tomography of American General Electric Company(GE),after data collection,send the scanned image to the workstation and calculate TCS by built - in Smart score. With statistical analysis,the two indicators were combined to build integrated prediction model to achieve the evaluation of MACE among elderly patients with SCAD. Results There were no significant differences in gender, age,BMI,smoking history,history of hypertension,history of diabetes mellitus and dyslipidemia between the two groups(P ﹥0. 05). NT-proBNP and TCS in MACE group were significantly higher than those in non - MACE group(P ﹤ 0. 05). Logistic regression model was constructed:Logit(P) = - 2. 602 + 0. 001NT-proBNP + 0. 010TCS,and the new combined index Logit (P)was obtained. The area under the curve(AUC)of receiver operating characteristic(ROC)of MACE occurring in elderly patients with SCAD predicted by new combined indicators was 0. 891〔 95% CI( 0. 847,0. 926 ),P ﹤ 0. 01 〕,and the sensitivity and specificity were 0. 788 and 0. 848 respectively;the AUC of ROC of MACE occurring in elderly patients with SCAD predicted by NT-proBNP was 0. 770〔95% CI(0. 715,0. 820),P ﹤ 0. 01〕,and the sensitivity and specificity were 0. 549 and 0. 808 respectively;the AUC of ROC of MACE occurring in elderly patients with SCAD predicted by TCS was 0. 833〔95% CI (0. 782,0. 876),P ﹤ 0. 01〕,and the sensitivity and specificity were 0. 779 and 0. 755 respectively. The AUC of MACE occurring in patients predicted by new combined indictors,NT-proBNP and TCS were significantly different(Z = 4. 83 and 2. 63 respectively,P ﹤ 0. 01);the AUC of MACE occurring in patients predicted by NT-proBNP and TCS were not significantly different(Z = 1. 56,P = 0. 12). Conclusion The value of NT-proBNP combined with TCS in evaluating the risk of prognosis among elderly patients with SCAD is better than that of any single indicator,and provides a more reliable method of early prediction of the poor prognosis among elderly patients with SCAD.关键词
老年人/稳定性冠心病/N末端B型利钠肽原/冠状动脉钙化总积分/主要不良心血管事件Key words
Aged/Stable coronary artery disease/N - terminal pro - B - type natriuretic peptide/Total coronary calcification score/Major adverse cardiovascular events分类
医药卫生引用本文复制引用
卞娜娜,胡立群,李红旗..N末端B型利钠肽原联合冠状动脉钙化总积分对老年稳定性冠心病患者预后风险评估的价值研究[J].中国全科医学,2017,20(1):62-66,5.基金项目
安徽省科技厅公益联动项目 （）
