联合检测血浆肌钙蛋白Ⅰ和脑钠肽对急性心力衰竭患者严重程度及预后判断的价值

Prognostic value of combined detection cardiac troponin I and brain natriuretic peptide in plasma for patients ;with acute heart failure

目的：探讨血浆肌钙蛋白Ⅰ和脑钠肽联合检测对急性心力衰竭患者预后判断的临床意义。方法急性心力衰竭患者88例，依据患者病情转归情况分为好转出院组68例与死亡组20例。另选同期健康体检的健康人群50例作为对照组。比较分析三组受试者 cTnI 与 BNP 水平的变化情况。结果好转出院组和死亡组患者入院时 cTnI（1.09±0．91）ng／mL 和（3．07±1．35）ng／mL，BNP（182．76±34．19）pg／mL 和（226．84±51．73）pg／mL 均明显高于对照组，差异均有统计学意义（t ＝9．15，9．90，26．11，13．99；P ＜0．05）；好转出院组患者出院前 cTnI（0．09±0．05）ng／mL 与 BNP（65．33±20．61）pg／mL 高于对照组，差异均无统计学意义（t ＝1．35，0．83；P ＞0．05）；而死亡组患者死亡前 cTnI （4．38±1．59）ng／mL 与 BNP（254．39±62．81）pg／mL 均明显高于对照组，经统计学处理，差异均有统计学意义（t ＝12．09，13．52；P ＜0．05）。与好转出院组患者相比，死亡组患者入院时和死亡前 cTnI 与 BNP 水平均明显提高（t ＝6．16，3．59，12．06，13．25；P ＜0．05）。与心功能Ⅲ级患者相比，心功能Ⅳ级患者 cTnI 水平明显提高，差异均有统计学意义（t ＝6．64；P ＜0.05）。结论cTnⅠ和 BNP 联合检测对急性心衰患者预后判断具有一定的指导价值，为临床治疗方案的选择提供了参考。

Objective To explore the clinical significance of combined detection of plasma BNP and cTnⅠin predicting the prognosis of patients with acute heart failure.Methods 88 patients with acute heart failure were selected in emergency department of our hospital.According to the outcomes of patients＇condition,the patients were divided into improved and discharged group （n =58）and died group （n =30）.And 50 healthy people were selected as control group during the same period in our hospital.The changes of cTnI and BNP levels in the three groups were compared and analyzed.Results Compared with the control group,in the improved and discharged group and died group,the levels of cTnI were （1.09 ±0.91）ng/mL and （3.07 ±1.35）ng/mL,the levels of BNP were （182.76 ± 34.19）pg/mL and （226.84 ±51.73）pg/mL,which were significantly increased,the differences were statistically significant （t =9.15,9.90,26.11,13.99,all P 〈0.05 ）.Compared with the control group,the patients before discharge in improved and discharged group,the levels of cTnI and BNP were （0.09 ±0.05）ng/mL and （65.33 ± 20.61）pg/mL,which were increased,the differences were not statistically significant （t =1.35,0.83,all P 〉0.05）. Compared with the control group,the patients before death in died group,the levels of cTnI and BNP were （4.38 ± 1.59）ng/mL and （254.39 ±62.81 ）pg/mL,which were significantly increased,the differences were statistically significant （t =12.09,13.52,all P 〈0.05）.Compared with the improved and discharged group,the patients in died group admitted to hospital and before death,the levels of cTnI and BNP were increased significantly,the differences were statistically significant （t =6.16,3.59,12.06,13.25,all P 〈0.05）.Compared with the cardiac function in patients with grade Ⅲ,the cardiac function in patients with grade Ⅳ,the levels of cTnI increased significantly,the difference was statistically significant （t =6.64,P 〈0.05）.Conclusion Combined detection cTnⅠ and BNP has a guiding value for the prognosis of patients with acute heart failure.It provides a reference for clinical treatment.