降钙素原对急性严重心力衰竭预后价值的分析

Analysis of prognostic value of procalcitonin in patients with acute severe heart failure

目的:探讨降钙素原(PCT)与急性严重心力衰竭临床预后的相关性。方法:收集诊断为急性严重心力衰竭而无活动性感染的患者共88例。根据PCT升高与否将88例分为PCT升高组、PCT不升高组,记录其临床特点、相关检查结果、住院期间死亡事件,随访患者出院1年内再住院事件及心源性死亡事件。结果:PCT升高组较PCT不升高组有更严重的多脏器灌注受损指标和更高的住院期间死亡事件、出院后1年内再住院事件及心源性死亡事件发生率(P<0.05)。PCT对急性严重心力衰竭而无活动性感染患者住院期间死亡事件、1年内再住院事件及心源性死亡事件的ROC曲线下面积分别为:0.72、0.65、0.73,灵敏度:0.82、0.51、0.48,特异度:0.56、0.80、0.89。结论:血清PCT值与急性严重心力衰竭而无活动性感染患者的临床预后显著相关,可作为临床预后评估的一项新的独立的重要化验指标。

Objective：To investigate the correlation between procalcitonin（PCT）and clinical prognosis in patients with acute severe heart failure.Method：Eighty-eight patients with acute severe heart failure without active infection were collected in our hospital.They were divided into two groups according to whether the procalcitonin was elevated or not.The clinical characteristics,the main examination results and death events during hospitalization were recorded,and the re-hospitalization events and cardiac death events were observed within one year after discharge.Result：The organ damage index in the group of PCT-elevated were more severe,and this group had higher in-hospital mortalityrate,and more readmission events and cardiac death events within one year after discharge,compared with the group without PCT-elevated（P〈0.05）.The ROC curve was used to analyze the relevance of PCT in patients with acute severe heart failure who had no active infection,in-hospital mortality,one year readmission and cardiac death.The area under ROC curve（AUC）was：0.72,0.65,0.73.The sensitivity was82%,51%,48%,respectively and specificity was 56%,80%,89%,respectively.Conclusion：Serum PCT is significantly associated with the clinical outcome of patients with acute severe heart failure without active infection,and can be used as a new independent and important laboratory indicator in clinical prognosis evaluation.