Tei指数和血浆脑钠肽对前壁心肌梗死长期预后的预测价值

Predictive value of Tei index and plasma brain natriuretic peptide on long-term prognosis in patients with anterior myocardial infarction

目的探讨Tei指数和血浆脑钠肽(BNP)对前壁心肌梗死(MI)患者长期随访主要不良心血管事件(MACE)的预测价值。方法选取前壁MI患者238例,根据BNP和Tei中位数分组:G1组(Tei≤0.66,BNP≤532.60ng/mL,n=70),G2组(Tei≤0.66,BNP>532.60ng/mL,n=51),G3组(Tei>0.66,BNP≤532.60ng/mL,n=50),G4组(Tei>0.66,BNP>532.60ng/mL,n=67)。随访终点为发生MACE。结果 BNP与Tei呈强正相关(r=0.582,P=0.000),Tei(β=0.658,P<0.05)进入BNP回归方程。4组患者无MACE生存率比较,差异有统计学意义(χ2=9.975,P=0.019);Cox回归分析显示Tei指数、BNP是MACE事件的独立预测因子。Tei联合BNP对MACE有更强的预测价值(AUC=0.781,95%CI:0.721~0.841,P=0.000),灵敏度为72.52%,特异度为76.89%。结论 Tei联合BNP对前壁MI长期随访MACE有较强的预测价值。

Objective To explore the predictive value of Tei index and plasma brain natriuretic peptide（BNP）on major adverse cardiovascular events（MACE）during long term follow up in the patients with anterior myocardial infarction（MI）.MethodsA total of 238 patients with anterior MI were selected and divided into four groups according to the median of Tei index and BNP：G1 group（Tei≤0.66,BNP≤532.60 ng/mL,n=70）,G2 group（Tei≤0.66,BNP〉532.60 ng/mL,n=51）,G3 group（Tei〉0.66,BNP≤532.60 ng/mL,n=50）and G4 group（Tei0.66,BNP532.60 ng/mL,n=67）.The follow up end was the MACE occurrence.Results There was a significant positive correlation between the Tei index and BNP（r=0.582,P=0.000）.Tei entered the BNP regression equation（β=0.658,P〈0.05）.The MACE-free survival rate had no statistical difference among 4 groups（χ2=9.975,P=0.019）.The Cox regression analysis showed that Tei index and BNP were the independent predictive factors for MACE.Tei combined with BNP had stronger predictive value to MACE（AUC=0.781,95 CI：0.721-0.841,P=0.000）,its sensitivity was72.52%and specificity was 76.89%.Conclusion Tei combined with BNP has stronger predictive value for anterior MI during long term follow up.