CKMB、cT-nT、NT-proBNP联合检测在NSCLC并发心力衰竭患者病情评估、预后中的价值

Value of combined detection of CKMB,cT⁃nT and NT⁃proBNP in the evaluation and prognosis of patients with NSCLC complicated with heart failure

目的分析心肌酶谱(CKMB)、肌钙蛋白T(CcTnT)、N-末端利钠肽前体(NT-proBNP)联合检测在非小细胞肺癌(NSCLC)并发心力衰竭患者病情评估、预后中的价值。方法选取2019年6月至2021年6月上海市奉贤区中心医院收治的124例NSCLC患者,采用双向侧流免疫法检测血清CKMB、cT-nT、NT-proBNP水平,对比NSCLC有无心力衰竭患者血清CKMB、cT-nT、NT-proBNP水平、比较不同心功能分级血清CKMB、c T-nT、NT-proBNP水平及三项指标单独诊断与联合诊断的预后价值,观察NSCLC并发心力衰竭患者预后情况,分析血清CKMB、cT-nT、NT-proBNP与NSCLC并发心力衰竭相关性。结果根据是否伴有心力衰竭将NSCLC患者分为NSCLC组(85例)和NSCLC并发心力衰竭组(39例),NSCLC并发心力衰竭组CKMB、cT-nT、NT-proBNP水平高于NSCLC组,差异有统计学意义(P<0.05)。NSCLC并发心力衰竭组Ⅳ级CKMB、c T-nT、NT-proBNP水平均高于Ⅱ、Ⅲ级;Ⅲ级CKMB、c T-nT、NT-proBNP水平均高于Ⅱ,差异有统计学意义(P<0.05)。通过多因素分析得知:年龄、吸烟史、临床病理分期、肺部感染、心功能分级、血清CKMB、c T-nT、NT-proBNP为影响NSCLC并发心力衰竭的预后因素(P<0.05)。CKMB、c T-nT、NT-proBNP联合诊断的敏感度、特异度分别高于CKMB、cT-nT、NT-proBNP单独检测(P<0.05)。Pearson相关性分析显示,血清CKMB、cT-nT、NT-proBNP与NSCLC并发心力衰竭呈正相关(r_(CKMB)=0.697,r_(cT-nT)=0.713,rNT-p_(roBNP)=0.726,P均<0.001)。结论血清CKMB、c T-nT、NT-proBNP联合检测可提高NSCLC并发心力衰竭诊断价值,能够有效评估病情严重程度,可作为患者预后判断的重要指标。

Objective To analyze the value of combined detection of CreatineKinase⁃MB(CKMB),Cardiac troponinT(cTnT),N⁃terminal pro⁃B⁃type natriuretic peptide(NT⁃proBNP)in the evaluation and prognosis of patients with non⁃small cell lung cancer(NSCLC)complicated with heart failure.Methods A total of 124 NSCLC patients admitted to Shanghai Fengxian District Central Hospital from June 2019 to June 2021 were selected,and the two⁃way lateral flow immunoassay was used to detect serum levels of CKMB,cT⁃nT and NT⁃proBNP,and the serum levels of CKMB,cT⁃nT,NT⁃proBNP in NSCLC patients with to compare the levels of serum CKMB,cT⁃nT and NT⁃proBNP in different cardiac function grades and without heart failure,and the prognostic value of the three indicators alone and combined diagnosis were compared,the prognosis of patients with NSCLC complicated with heart failure was observed,and the relationship between serum CKMB,cT⁃nT,NT⁃proBNP and NSCLC complicated with heart failure was analyzed.Results NSCLC patients were divided into the NSCLC group(85 cases)and NSCLC complicated with heart failure group(39 cases)according to whether they were accompanied by heart failure.The levels of CKMB,cT⁃nT and NT⁃proBNP in the NSCLC complicated with heart failure group were higher than those in the NSCLC group,the difference was statistically significant(P<0.05).The levels of CKMB,cT⁃nT and NT⁃proBNP in gradeⅣof NSCLC complicated with heart failure were higher than those in gradeⅡandⅢ.The levels of CKMB,cT⁃nT and NT⁃proBNP in classⅢwere higher than those in classⅡ,and the difference was statistically significant(P<0.05).Multivariate analysis showed that age,smoking history,clinicopathological stage,lung infection,cardiac function classification,serum CKMB,cT⁃nT,NT⁃proBNP were prognostic factors affecting NSCLC complicated with heart failure(P<0.05).The sensitivity and specificity of combined diagnosis of CKMB,cT⁃nT and NT⁃proBNP were higher than those of CKMB,cT⁃nT and NT⁃proBNP alone(P<0.05).Pearson correlation analysis showed that serum CKMB,cT⁃nT and NT⁃proBNP were positively correlated with NSCLC complicated with heart failure(r_(CKMB)=0.697,r_(cT⁃nT)=0.713,r_(NT⁃proBNP)=0.726,P<0.001).Conclusion The combined detection of serum CKMB,cT⁃nT and NT⁃proBNP can improve the diagnostic value of NSCLC complicated with heart failure,can effectively evaluate the severity of the disease,and can be used as an important indicator for the prognosis of patients.