血尿酸和氨基末端脑钠肽前体在急性心力衰竭中的诊断和预后预测价值

Diagnosis and Prognostic Prognosis Value of Serum Uric Acid and N-terminal-Pro-brain Natriuretic Peptide in Patients with Acute Heart Failure

目的探讨血尿酸和氨基末端脑钠肽前体(N-terminalpro-brain natriuretic peptide,NT-pro BNP)联合检测在急性心力衰竭(acute heart failure,AHF)中的诊断和预后预测价值。方法选择我院同期收治的AHF 89例(AHF组)和健康体检者50例(正常对照组),测定比较血尿酸和NT-Pro BNP水平,评估血尿酸和NT-Pro BNP诊断AHF的价值及获随访AHF 81例的心血管事件发生率。结果血尿酸及NT-proBNP水平AHF组分别为(408.4±113.8)μmol/L、(4100.7±1140.0)pg/ml,正常对照组分别为(326.6±85.4)μmol/L、(291.6±87.9)pg/ml,两组比较差异均有统计学意义(P<0.01)。血尿酸水平为416μmol/L时,诊断AHF的灵敏度为69.7%,特异度为60.0%;NT-proBNP水平为4100 pg/ml时,诊断AHF的灵敏度为60.7%,特异度为80.0%。血清高尿酸和高NT-Pro BNP水平AHF患者心血管事件发生率显著高于血清低尿酸及低NT-Pro BNP水平患者,差异有统计学意义(P<0.01)。结论血尿酸和NT-ProBNP联合检测可提高AHF的诊断水平及预后预测价值。

Objective To explore serum uric acid and N-terminal pro-brain natriuretic peptide （NT-pro BNP） in di- agnosis and prognostic prognosis value of acute heart failure （ AHF ）. Methods A total of 89 patients with AHF （ AHF group） and 50 healthy people （control group） were recruited in this study. Serum UA and NT-Pro BNP levels of the two groups were detected and compared. The value of Serum UA and NT-Pro BNP in diagnosis of AHF, and incidence of eadiovas- eular diseases in 81 follow-up patients were observed. Results Serum UA were （408.4 ± 113.8） μmol/L in AHF group and （326.6 ±85.4）μmol/L in control group, NT-Pro BNP were （4100.7 ± 1140.0） pg/ml in AHF group and （291. 6 ± 87.9） pg/ml in control group, and the differences were statistically significant （P 〈 0. 01 ）. The serum UA level was 416 p, mol/L with a AHF sensitivity of 69.7% and a specificity of 60.0% ; NT-Pro BNP level was 4100 pg/ml with a AHF sensitivity of 60.7% and a specifieity of 80.0%. Patients with high UA and NT-Pro BNP levels were at higher risk of cardiac events than those with low UA and NT-ProBNP levels （P 〈 0.01 ）. Conclusion The method of UA combined with NT-Pro BNP detection may improve the diagnosis and prognostic prognosis value of AHF.