不同左心室射血分数心力衰竭患者NT-proBNP水平和5年生存率分析

Analysis of NT-proBNP and 5-year survival rate in patients with different left ventricular ejection fraction and heart failure

目的检验不同左心室射血分数心力衰竭患者的NT-proBNP浓度,分析患者第1年、2年和5年的生存率,为临床诊治提供参考。方法从西安市北方医院心血管内科2012年1月至2014年1月诊治的心力衰竭患者中,选取3种不同左心室射血分数心力衰竭患者180例作为研究对象。根据左室射血分数(LVEF)分为射血分数降低心力衰竭48例(HfrEF组),射血分数中间范围型心力衰竭43例(HfmrEF组)和射血分数保留心力衰竭89例(HfpEF组)。比较各组患者的各项基本资料和NT-proBNP浓度;记录分析各组患者的生存率。结果HfpEF组患者的平均年龄为(68.25±14.23)岁,明显大于HFrEF组的(58.52±13.24)岁和HFmrEF组的(63.72±12.41)岁,女性患者占比为50.56%,明显高于HFrEF组的27.08%和HFmrEF组的37.21%,NT-proBNP浓度为(1 928.13±252.73)ng/L,明显高于HFrEF组的(5 195.40±220.59)ng/L和HFmrEF组的(3 875.27±249.34)ng/L,上述各项指标组间比较差异均有统计学意义(P<0.05);各组心力衰竭患者的第5年死亡率明显高于第1、2年死亡率,差异均有统计学意义(P<0.05);三组患者1年、2年、3年死亡率比较差异无统计学意义(P>0.05);心力衰竭患者第1、2、5年的全因死亡率分别为10.32%、21.52%、34.47%,差异有统计学意义(P<0.05)。结论通过检测不同左心室射血分数心力衰竭患者的NT-proBNP水平可以对患者的危险程度进行更加准确的评估,分析心力衰竭患者5年的生存率,对预后进行更准确的判断。

Objective To study the amino-terminal pro-brain natriuretic peptide(NT-proBNP) concentration test in patients with left ventricular ejection fraction and heart failure, and to analyze the survival rate of patients in the first, second and fifth years, so as to provide reference for clinical diagnosis and treatment. Methods A total of 180 patients with three different left ventricular ejection fraction heart failure were selected from the patients with heart failure diagnosed and treated in Department of Cardiovascular Medicine of Xi’an North Hospital from January 2012 to January 2014. According to the left ventricular ejection fraction(LVEF), the patients were divided into the ejection fraction decreased heart failure in 48 cases(HfrEF group), the ejection fraction in the middle range of heart failure in 43 cases(HfmrEF group) and the ejection fraction retained heart failure in 89 cases(HfpEF group). The basic data and NT-proBNP concentrations were compared between the groups. The survival rate of each group was recorded and analyzed. Results The mean age of the patients in the HfpEF group was(68.25±14.23) years old, which was significantly higher than(58.52±13.24) years old of the HFrEF group and(63.72±12.41) years old of the HFmrEF group;the female patients accounted for 50.56%, which was significantly higher than 27.08% of the HFrEF group and 37.21% of the HFmrEF group;the concentration of NT-proBNP was(1 928.13±252.73) ng/L, which was significantly higher than(5 195.40±220.59) ng/L in the HFrEF group and(3 875.27±249.34) ng/L in the HFmrEF group(all P<0.05). The 5th year mortality of patients with heart failure was significantly higher than that of the 1st and 2nd years(P<0.05);there was no significant difference in mortality between the three groups at 1 year, 2 years, and 3 years(P>0.05);all-cause mortality in patients with heart failure at 1st, 2nd, and 5th years was 10.32%, 21.52%, and 34.47%, respectively, and the differences were statistically significant(all P<0.05). Conclusion By measuring the level of NT-proBNP in patients with different left ventricular ejection fraction and heart failure, the patient’s risk can be more accurately assessed. The 5-year survival rate of patients with heart failure can be used to improve the prognosis of patients and make a more accurate judgment of the prognosis of patients.