NT-proBNP在老年慢性心力衰竭患者病情评估及预后判断的应用价值分析

Analysis on the Application Value of NT-proBNP in Evaluating the Severity and Prognosis of Elderly Patients with Chronic Heart Failure

目的探讨N末端B型钠尿肽前体(NT-proBNP)在老年慢性心力衰竭患者的病情评估及预后判断的应用价值。方法选取我院2013年7月至2015年5月期间收治的150例老年慢性心力衰竭患者,检测并记录患者的血浆及尿液NT-proBNP水平。患者出院后进行12个月的随访,按照此期间是否慢性心力衰竭复发,将其分为观察组(有复发,58例)和对照组(无复发,92例)。分析两组患者的NT-proBNP水平及两者之间的关联。结果随访期间,观察组血浆NT-proBNP水平明显高于对照组,差异有统计学意义(P<0.05)。依据NT-pro BNP对判定慢性心力衰竭患者预后的ROC曲线,其浓度水平与老年慢性心力衰竭急性发作患者的相关预测要求相符。以1 024.00 ng/L NT-proBNP为临界值,绘制K-M曲线,两组患者预后心力衰竭复发率比较差异有统计学意义(P<0.05)。结论 NT-proBNP水平越高,患者发生心力衰竭急性发作的风险越大,提示检测尿液NT-proBNP水平对于老年慢性心力衰竭患者的危险因素预防、病情评估及预后判断均具有临床应用价值。

Objective To explore the application value of N terminal B type natriuretic peptide （NT-proBNP） in evaluating the severity and prognosis of elderly patients with chronic heart failure. Methods 150 cases of elderly patients with chronic heart failure admitted to our hospital from July 2013 to May 2015 were selected, and their plasmatic and urine NT-proBNP were detected and recorded. Patients were followed up for 12 months and divided into observation group （with recurrence, 58 cases） and control group （without recurrence, 92 cases） according to the recurrence of chronic heart failure during this period. The NT-proBNP levels of two groups and the correlation between them were analyzed. Results During the follow-up period, the plasmatic NT-proBNP level of observation group was significantly higher than that of control group, with statistical difference （P 〈0.05）. According to the NT-proBNP of ROC curve for judging the prognosis of patients with chronic heart failure, its concentration level was consistent with the relative prediction requirement. With 1 024.00 ng/L of NT-proBNP as the critical value, the K-M curve was drawn, and the recurrence rate of chronic heart failure had statistical difference between two groups （P〈0.05）. Conclusions Patients with higher NT-proBNP level have greater risk of acute attack of heart failure. It suggestes that the detection of urine NT-proBNP level for elderly patients with chronic heart failure has clinical application value in the prevention of risk factors, disease evalustion and prognosis.