BNP、MYO、CK-MB和cTnI2与慢性心力衰竭患者心功能及发生MACE的关系

Correlation of BNP,MYO,CK-MB and cTnI2 with cardiac function and occurrence of MACE in patients with chronic heart failure

目的 探讨脑钠肽(BNP)、肌红蛋白(MYO)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I2(cTnI2)与慢性心力衰竭(CHF)患者心功能和近期主要不良心血管事件(MACE)发生的关系。方法选取2019年1月至2021年12月北京友谊医院收治的124例CHF患者作为研究组,另选取同期进行健康体检的志愿者110名为对照组。比较两组BNP、MYO、CK-MB、cTnI2及心功能;分析研究组BNP、MYO、CK-MB、cTnI2与心功能的关系。随访CHF患者3个月,按是否发生MACE分成MACE组(n=36)和非MACE组(n=88),并多因素分析CHF患者发生MACE的危险因素,ROC曲线分析BNP、MYO、CK-MB、cTnI2水平对CHF患者发生MACE的预测价值。结果 与对照组相比,研究组的BNP、MYO、CK-MB、cTnI2、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)均更高,左心室射血分数(LVEF)更低,差异均有统计学意义(P<0.05)。Pearson显示,BNP、MYO、CK-MB、c TnI2与LVEF负相关,与LVESD、LVEDD正相关(P<0.05)。多因素分析显示,BNP、MYO、CK-MB、c TnI2是CHF患者发生MACE的独立危险因素(P<0.05)。ROC曲线显示,BNP、MYO、CK-MB、cTnI2及四者联合检测曲线下面积为0.744、0.721、0.694、0.751、0.887。结论 BNP、MYO、CK-MB、cTnI2水平与CHF患者心功能及发生MACE密切相关,联合检测对预测发生MACE的有重要意义。

Objective To investigate the relationship between brain natriuretic peptide(BNP),myoglobin(MYO),creatine kinase isoenzyme(CK-MB),cardiac troponin I 2(cTnI2)and cardiac function and recent major adverse cardiovascular events(MACE) in patients with chronic heart failure(CHF).Methods A total of 124 CHF patients admitted to Beijing Friendship Hospital from January 2019 to December2021 were selected,and 110 volunteers who underwent physical examination during the same period were selected as the control group. BNP,MYO,CK-MB,cTnI2 and cardiac function were compared between the two groups. The relationship between BNP,MYO,CK-MB,cTnI2 and cardiac function was analyzed. CHF patients were followed up for 3 months,and divided into the MACE group(n=36)and the non-MACE group(n=88)according to the occurrence of MACE. The risk factors of MACE in CHF patients were analyzed by multivariate analysis. The predictive value of BNP,MYO,CK-MB and cTnI2 levels on MACE in CHF patients was analyzed by ROC curve. Results Compared with the control group,the BNP,MYO,CK-MB,cTnI2,left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)in the study group were higher,and the left ventricular ejection fraction(LVEF)was lower,the differences were statistically significant(P<0.05). Pearson showed that BNP,MYO,CK-MB and cTnI2 in CHF patients were negatively correlated with LVEF,and positively correlated with LVESD and LVEDD(P<0.05). Multivariate analysis showed that BNP,MYO,CK-MB and c TnI2 were independent risk factors for MACE in CHF patients(P<0.05). The ROC curve showed that the area under the curve of BNP,MYO,CK-MB,cTnI2 and their combined detection were 0.744,0.721,0.694,0.751 and0.887. Conclusion The levels of BNP,MYO,CK-MB and c TnI2 are closely related to cardiac function and the occurrence of MACE in CHF patients. The combined detection of BNP,MYO,CK-MB and c TnI2 is of great significance in predicting the occurrence of MACE.