NT-proBNP、cTnI、Mb对风湿性心脏病患者人工瓣膜置换术预后情况的预测价值

Predictive Value of NT-proBNP,cTnI and Mb in the Prognosis of Artificial Valve Replacement for Rheumatic Heart Disease

目的:探讨N-末端脑钠肽前体(NT-proBNP)、心肌肌钙蛋白I(cTnI)、肌红蛋白(Mb)对风湿性心脏病(RHD)人工瓣膜置换术预后情况的预测价值。方法:选取2020年1月-2022年12月烟台市烟台山医院收治的RHD患者60例为研究对象,均接受人工瓣膜置换术治疗。比较预后良好组(n=47)、预后不良组(n=13)NT-proBNP、cTnI、Mb、左室射血分数(LVEF)水平,分析NT-proBNP、cTnI、Mb与LVEF的相关性,分析NT-proBNP、cTnI、Mb对RHD预后不良的预测效能。结果:预后不良组NT-proBNP、cTnI、Mb水平高于预后良好组,LVEF水平低于预后良好组,差异有统计学意义(P<0.05)。Pearson相关性分析结果显示,NT-proBNP、cTnI、Mb分别与LVEF呈负相关,差异有统计学意义(r=-0.685、-0.636、-0.614,P=0.016、0.022、0.027)。NT-proBNP、cTnI、Mb联合预测RHD预后不良的曲线下面积高于各单一指标,差异有统计学意义(P<0.05)。结论:NT-proBNP、cTnI、Mb与RHD预后情况相关,RHD患者血清NT-proBNP、cTnI、Mb含量升高,提示病情恶化风险增加,NT-proBNP、cTnI、Mb联合预测RHD预后有一定价值。

Objective:To investigate the predictive value of N-terminal brain natriuretic peptide precursor(NT-proBNP),cardiac troponin I(cTnI)and myoglobin(Mb)in the prognosis of artificial valve replacement for rheumatic heart disease(RHD).Methods:Sixty patients with RHD treated in Yantai City Yantai Mountain Hospital from January 2020 to December 2022 were selected as the study objects,all of whom received artificial valve replacement treatment.The levels of NT-proBNP,cTnI,Mb and left ventric-ular ejection fraction(LVEF)were compared between the good prognosis group(n=47)and the poor prognosis group(n=13).The correlation between NT-proBNP,cTnI,Mb and LVEF was analyzed,and the predictive efficacy of NT-proBNP,cTnI and Mb for poor prognosis of RHD was analyzed.Results:The levels of NT-proBNP,cTnI and Mb in the poor prognosis group were higher than those in the good prognosis group,and the level of LVEF was lower than that in the good prognosis group,with statistical sig-nificance(P<0.05).Pearson correlation analysis showed that NT-proBNP,cTnI and Mb were negatively correlated with LVEF,re-spectively,and the differences were statistically significant(r=-0.685,-0.636,-0.614,P=0.016,0.022,0.027).The area under curve of NT-proBNP,cTnI and Mb combined in predicting poor prognosis of RHD was higher than that of each single index,and the difference was statistically significant(P<0.05).Conclusion:NT-proBNP,cTnI and Mb are related to the prognosis of RHD.The increase of serum levels of NT-proBNP,cTnI and Mb in patients with RHD indicates an increased risk of disease deteriora-tion.The combination of NT-proBNP,cTnI and Mb has certain value in predicting the prognosis of RHD.