AMI后心力衰竭患者血清NT-proBNP水平的变化及其变化差值对患者预后的预测价值

Changes of serum NT-proBNP level and prognostic value of its difference in patients with heart failure after acute myocardial infarction

目的探究急性心肌梗死(AMI)后心力衰竭(心衰)治疗过程中血清氨基末端B型脑钠肽前体(NT-proBNP)水平变化,并分析其变化差值对患者预后的预测价值,为临床治疗提供参考。方法选取2021年1月至2022年3月郑州大学第一附属医院收治的182例AMI后心衰患者,治疗过程中采用酶联免疫法检测血清NT-proBNP水平,随访9个月,根据治疗期间是否发生主要不良心血管事件(MACE)进行预后分组,比较血清NT-proBNP水平变化及变化差值,采用受试者工作特征曲线(ROC)获取曲线下面积(AUC)分析血清NT-proBNP水平变化差值对AMI后心衰患者预后的预测价值。结果治疗前和治疗1个月、2个月、3个月后,MACE a组患者的血清NT-proBNP水平明显高于无MACE a组,差异均有统计学意义(P<0.05);治疗前和治疗1个月、2个月、3个月、4个月、5个月、6个月后,MACE b组患者的血清NT-proBNP水平明显高于无MACE b组,差异均有统计学意义(P<0.05);治疗前和治疗1个月、2个月、3个月、4个月、5个月、6个月、7个月、8个月、9个月后,MACE c组患者的血清NT-proBNP水平均明显高于无MACE c组,差异均具有统计学意义(P<0.05);Δ1 NT-proBNP、Δ2 NT-proBNP、Δ3 NT-proBNP预测治疗3个月、6个月、9个月预后的AUC分别为0.756、0.804、0.809(P<0.05)。结论血清NT-proBNP水平变化与AMI后心衰患者预后有关,治疗过程中监测血清NT-proBNP水平变化对临床预后有重要预测价值。

Objective To explore the changes of serum amino terminal B-type brain natriuretic peptide precursor(NT-proBNP)levels during the treatment of heart failure after acute myocardial infarction(AMI),and analyze the predictive value of the difference in prognosis of patients,so as to provide reference for clinical treatment.Methods A total of 182 patients with heart failure after AMI admitted to the First Affiliated Hospital of Zhengzhou University from January 2021 to March 2022 were selected.Serum NT-proBNP levels were detected by enzyme-linked immunoassay during treatment.The patients were followed up for 9 months,and prognostic groups were divided according to whether major adverse cardiovascular events(MACE)occurred during treatment.The change and difference of serum NT-proBNP level were compared,and the area under the curve(AUC)was obtained by receiver operating characteristic curve(ROC)to analyze the prognostic value of serum NT-proBNP level difference in patients with heart failure after AMI.Results Before treatment,and at 1,2,and 3 months after treatment,the serum NT-proBNP level in MACE a group was significantly higher than that in non-MACE a group(P<0.05).Before treatment and at 1,2,3,4,5 and 6 months after treatment,the serum NT-proBNP level in MACE b group was significantly higher than that in non-MACE b group(P<0.05).Before treatment and at 1,2,3,4,5,6,7,8,9 months after treatment,the serum NT-proBNP level in MACE c group was significantly higher than that in non-MACE c group(P<0.05).The AUC ofΔ1 NT-proBNP,Δ2 NT-proBNP,andΔ3 NT-proBNP for predicting prognosis at 3 months,6 months and 9 months after treatment were 0.756,0.804,and 0.809 months,respectively(P<0.05).Conclusion The change of serum NT-proBNP level is related to the prognosis of patients with heart failure after AMI.Monitoring the change of serum NT-proBNP level during treatment has important prognostic value for clinical prognosis.