血浆脑钠肽及血清胱抑素C对ARVC心力衰竭的预测价值研究

Predicting value of plasma BNP and serum Cys C on heart failure caused by arrhythmogenic right ventricular cardiomyopathy

目的研究血浆脑钠肽(BNP)与血清胱抑素C(Cys C)对致心律失常型右室心肌病(ARVC)引起的心力衰竭的预测价值。方法选择32例ARVC病例,检测其血浆BNP及血清Cys C水平,并随访18个月观察心力衰竭发生情况。结果 ARVC患者入院时的血浆BNP、血清Cys C水平均随心功能的降低而呈上升趋势,不同心功能组的差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,血浆BNP(OR=4.118)、血清Cys C(OR=6.358)是ARVC患者心力衰竭的独立预测因子。当BNP与Cys C分别取732.45ng/L与2.16mg/L时,对心力衰竭预测的灵敏度与特异度均为最高。以随访出现心力衰竭为终点结局进行生存分析,BNP低危组(≤732.45ng/L)的生存率高于高危组(P<0.01);Cys C低危组(≤2.16mg/L)的生存率也高于高危组(P<0.01)。结论血浆BNP与血清Cys C水平对于ARVC导致的心力衰竭有较高的预测价值。

Objective To study the predicting value of plasma BNP and serum Cys C on heart failure caused by arrhythmo- genie right ventricular cardiomyopathy（AVRC）. Methods Thirty-two patients with AVRC were chosen. The plasma BNP and serum Cys C were tested. All subjects were followed up for 18 months to observe the happening of heart failure. Results The levels of plasma BNP and serum Cys C at admission in ARVC patients showed the increasing trend along with the decrease of heart function,and the difference among the groups with different heart functions were statistically significant（P〈0.05）. The multivariate Logistic regression analysis showed that plasma BNP（OR=4. 118） and serum Cys C （OR=6. 358）were the independent predicting factors for heart failure in AVRC patients. When BNP and Cys C had the cutoff values of 732.45 ng/L and 2.16 mg/L,their sensitivity and specificityfor predicting heart failure were highest. In the survival analysis with the heart failure occurrence at follow up as the endpoint outcome,the survival rate of the low risk BNP group （4732.45 ng/L）was higher than that of the high risk BNP group（P〈0.01） ,and the survival rate of the low risk Cys C group （42.16 mg/L）was higher than that of the high risk Cys C group（P〈0.01）. Conclusion The plasma BNP and serum Cys C levels had highere predicting value on heart failure caused by AVRC.