CK-MB、BNP及纤维蛋白原/白蛋白比值对老年慢性心力衰竭病人再入院率的预测价值

Predictive value of CK-MB,BNP and fibrinogen to albumin ratio on readmission rate in elderly patients with chronic heart failure

目的探讨肌酸激酶同工酶(CK-MB)、BNP及纤维蛋白原/白蛋白比值(FAR)对老年CHF病人再入院率的预测价值。方法收集2018年3月至2020年10月本院收治的CHF病人132例,其中NYHA心功能分级Ⅱ级55例、Ⅲ级41例、Ⅳ级36例。所有病人随访1年,根据是否再次入院分为再次入院组(45例)和未再次入院组(87例)。比较2组血清CRP、降钙素原(PCT)、BNP、CK-MB、FAR水平。采用ROC曲线分析CRP、PCT、CK-MB、BNP、FAR对CHF病人再次入院的预测价值。结果心功能Ⅱ、Ⅲ、Ⅳ级病人CRP、PCT、BNP、CK-MB水平及FAR依次显著升高,不同心功能级别间比较差异均有统计学意义(P<0.05)。与未再次入院组相比,再次入院组病人CRP、PCT、BNP、CK-MB及FAR水平较高(P<0.05)。ROC曲线显示,CRP、PCT、BNP、CK-MB、FAR预测CHF病人再次入院的AUC分别为0.790、0.785、0.804、0.841、0.869,BNP、CK-MB、FAR三者联合预测CHF病人再次入院的AUC为0.884,灵敏度、特异度分别为82.20%、88.50%。结论血清CK-MB、BNP、FAR在CHF再次入院病人中呈高水平,三者联合检测对CHF病人再次入院具有一定的临床预测价值。

Objective To investigate the predictive value of creatine kinase isoenzyme(CK-MB),B-type natriuretic peptide(BNP)and fibrinogen to albumin ratio(FAR)on readmission rate in the elderly patients with chronic heart failure(CHF).Methods A total of 132 CHF patients admitted to ouRhospital from March 2018 to OctobeR2020 were enrolled.According to the New York Heart Association(NYHA)cardiac function classification,there were 55 cases of gradeⅡ,41 cases of gradeⅢand 36 cases of gradeⅣ.All the patients were followed up foR1 yeaRand were divided into the readmission group(45 cases)and the non-readmission group(87 cases)according to whetheRthey were readmitted.The serum levels of C-reactive protein(CRP),procalcitonin(PCT),BNP,CK-MB and FARin the two groups were detected and compared.ReceiveRoperating characteristic(ROC)curve was used to analyze the predictive value of CRP,PCT,CK-MB,BNP,and FARfoRreadmission in the elderly patients with CHF.Results The levels of CRP,PCT,BNP,CK-MB and FARin gradeⅡ,gradeⅢand gradeⅣgroup were significantly increased in turn(P<0.05).Compared with the non-readmission group,the levels of CRP,PCT,BNP,CK-MB and FARwere significantly higheRin the readmission group(P<0.05).The ROC curve showed that the area undeRthe curve(AUC)of CRP,PCT,BNP,CK-MB,and FARfoRpredicting readmission of CHF patients was 0.790,0.785,0.804,0.841,and 0.869,respectively.The AUC of the combination of BNP,CK-MB and FARto predict the readmission of CHF patients was 0.884,and the sensitivity and specificity was 82.20%and 88.50%,respectively.Conclusions The serum levels of CK-MB,BNP,and FARare high in CHF readmission patients,and the combination detection of the three indexes shows significant clinical value in predicting CHF readmission.