血浆NT-proBNP对特发性肺动脉高压预后预测价值研究

Clinical Studies of NT-proBNP in the Prognosis of Chinese Patients with IPAH

目的评价血浆NT-proBNP在IPAH预后预测中的价值。方法本研究入选2006年9月至2011年8月在研究参加单位住院的IPAH患者为研究对象。所有患者均于基线时测量血浆NT-proBNP水平。于2013年6月至12月对所有患者进行随访,收集患者生存状态、服用药物情况等信息。结果本研究平均随访时间为2.46±1.26年,其中23例患者死亡,生存87例。基线血浆NT-proBNP水平与WHO心功能分级、mPAP、CI及PVR存在明显相关性。通过ROC曲线分析发现血浆NT-proBNP预测死亡的界值为480pg/ml(AUC=0.74),敏感性为87.0%,特异性为62.1%。Kaplan-Meier生存分析发现NT-proBNP≥480pg/ml和<480pg/ml两组的生存率存在显著性差异(Log-rank检验,P=0.02)。结论血浆NT-proBNP是IPAH患者预后预测的独立危险因素。

Objective To evaluate the prognosis value of N-terminal（NT）-pro-brain natriuretic peptide（BNP） levels in idiopathic pulmonary arterial hypertension. Methods IPAH patients who were referred between Sep 2006 and Aug 2011 in attending hospitals were analyzed. NT-proBNP levels were measured in each patient at baseline. All the patients were followed up from Jun 2013 to Dec 2013. The primary endpoints were death and therapy medicine. Results In a mean follow-up period of 2.46±1.26 years, 23 patients died, and 87 patients survived. Plasma NT-proBNP level was correlated with WHO functional class, mPAP, CI and PVR. Receiver operating characteristic analysis identified≥480pg/ml as the best NT-proBNP threshold predicting fatal outcome for the study（sensitivity=87.0%, specificity=62.1%）. Kaplan-Meier survival analysis showed that there was significant difference between higher NT-proBNP group and lower group（Log-rank test, P=0.02）. Conclusions Plasma NT-proBNP is an independence risk factor for prognosis in patients with IPAH.