老年慢性心力衰竭患者NT-proBNP、UA水平与心功能分级、预后的相关性分析

Analysis of Correlation between NT-proBNP and UA Levels and Cardiac Function Classification and Prognosis in Patients with Chronic Heart Failure

【目的】探讨老年慢性心力衰竭患者氨基末端B型脑钠肽前体(NT-proBNP)和尿酸(UA)水平与心功能分级、预后的相关性。【方法】选取2016年10月至2017年8月本院收治70例老年慢性心衰患者的临床资料,对不同心功能分级和预后患者的血清NT-proBNP、UA水平进行比政,对其相关性进行分析,并绘制ROC曲线获得观察指标对预后的预测价值及切点值。【结果】血清NT-proBNP、UA水平均随着心功能分级的升高而升高,组间比较差异具有统计学意义(P<0.05)。相关性分析显示,NT-proBNP、UA水平与心功能分级均呈正相关(rNT-proBNP=0.143,P=0.006<0.05;rUA=0.115,P=0.026<0.05)。治疗后预后不良组和预后良好组NT-proBNP、UA水平均较治疗前明显降低,而预后不良组治疗前、治疗后NT-proBNP、UA水平均明显高于预后良好组,差异均具有统计学意义(P<0.05)。NT-proBNP预测患者预后不良的ROC曲线图显示,当NT-proBNP水平为10850pg/mL时敏感性和特异性最高,分别为73.4%和72.0%;UA预测患者预后不良的ROC曲线图显示,当UA为436.4μmol/L时敏感性和特异性最高,分别为60.3%和64.1%。【结论】老年慢性心力衰竭患者心功能分级越高其血清NT-proBNP、UA水平越高,患者预后越差,两者对判断患者预后有一定的指导作用。

【Objective】To study the correlation of cardiac function classification and prognosis with the level of NT-proBNP and uric acid of elderly patients with chronic heart failure.【Methods】The clinical data of 70 elderly tients with chronic heart failure admitted to our hospital from October 2016 to August 2017 were selected.The serum NT-proBNP and UA levels of patients with different cardiac function grades and prognosis were compared,and the correlation was analyzed.The ROC curve was drawn to obtain the predictive value and cut-off value of the observation indicators for prognosis.【Results】Serum NT-proBNP and UA levels increased with the increase of cardiac function classification,and there was a significant difference between the two groups(P<0.05).The correlation analysis showed that NT-proBNP and UA levels were positively correlated with,cardiac function classification(rNT-proBNP=0.143,P=0.006<0.05;rUA=0.115,P=0.026<0.05).After treatment,the levels of NT-proBNP and UA in the poor prognosis group and the good prognosis group were significantly lower than those before treatment,while the levels of NT-prjoBNP and UA in the poor prognosis group were significantly higher than those in the good prognosis group before and after treatment,with statistical significance(P<0.05).The ROC curve of NT-proBNP predicting poor prognosis showed that the sensitivity and specificity were the highest when NT-proBNP,level was 10 850 pg/mL,73.4%and 72.0%respectively.The ROC curve of UA predicting poor prognosis showed that the sensitivity and i specificity were,the highest(60.3%and 64.1%respectively)when UA was 436.4 umol/L.【Conclusion】The higher the grade of cardiac function in elderly patients with chronic heart failure,the higher the serum NT-proBNP and UA levels,the worse the prognosis of patients.Both of them have certain guiding role in judging the prognosis of patients.