中国全科医学2018，Vol.21Issue(18)：2179-2184,6.DOI:10.3969/j.issn.1007-9572.2018.00.165
血浆脑钠肽联合氨基末端脑钠肽前体与常规心功能指标对心脏外科瓣膜置换术患者预后的预测价值研究
Plasma BNP Combined with NT-proBNP versus Routine Cardiac Function Parameters for Predicting Postoperative Prognosis in Patients with Heart Valve Replacement Surgery:a Comparative Study
摘要
Abstract
Objective To evaluate the clinical application value of plasma brain natriuretic peptide(BNP) combined with N-terminal prohormone of brain natriuretic peptide(NT-proBNP) based on comparing its value for predicting postoperative prognosis of patients with heart valve replacement surgery with that of routine cardiac function parameters.Methods We enrolled 138 patients with rheumatic heart disease undergoing heart valve replacement surgery from Department of Cardiac Surgery,Sichuan Provincial People's Hospital from August 2014 to February 2016 and collected their baseline characteristics, measurement levels of plasma BNP,NT-proBNP and routine cardiac function parameters at 1 week after surgery.They were divided into good prognosis group and poor prognosis group based on the conditions during a 18 month-follow-up initiated at 1 month after discharge.Results Except 14 were lost to follow-up,the other 124 completing the follow-up were included in the final analysis.73 of them were found with good prognosis(good prognosis group),and other 51 with poor prognosis (poor prognosis group),the rate of poor prognosis was 41.1%(51/124).Multivariate Cox regression analysis showed that left ventricular end diastolic diameter(LVEDD)(RR=1.578,P=0.039),plasma BNP(RR=1.935,P=0.013) and NT-proBNP(RR=2.346,P<0.001) were the associated factors of poor prognosis after heart valve replacement surgery.For predicting the patient prognosis,the AUC of LVEDD,plasma BNP,and NT-proBNP were 0.774,0.814,and 0.800, respectively,and the AUC of plasma BNP combined with NT-proBNP was 0.856,with a corresponding specificity of 78.9%, and a sensitivity of 83.6%.Conclusion As its predictive accuracy for the prognosis of patients undergoing cardiac valve replacement surgery,plasma BNP combined with NT-proBNP is expected to be used as one of the clinical parameters for postoperative prognosis prediction of such patients.关键词
心脏瓣膜假体植入/利钠肽,脑/氨基末端脑钠肽前体/预后Key words
Heart valve prosthesis implantation/Natriuretic peptide,brain/N-terminal prohormone of brain natriuretic peptide/Prognosis分类
医药卫生引用本文复制引用
谭今,于涛,黄克力,刘科,杨倩..血浆脑钠肽联合氨基末端脑钠肽前体与常规心功能指标对心脏外科瓣膜置换术患者预后的预测价值研究[J].中国全科医学,2018,21(18):2179-2184,6.基金项目
浙江省教育厅科研计划项目(Y200803689) （Y200803689）
