Plasma N-terminal pro-brain natriuretic peptide levels in elderly patients with isolated diastolic dysfunction

Objective To investigate plasma N-terminal pro-brain natriuretic peptide (NT-BNP) levels and to assess their clinical significance in elderly patients with isolated diastolic dysfunction. Methods Plasma NT-BNP level were measured by electrochemiluminescence immunoassay in 34 symptomatic patients (Group 1), 34 asymptomatic patients (Group 2) with isolated diastolic dysfunction, and in 16 elderly healthy subjects (control group, Group 3), serving controls. Colored Doppler echocardiography was performed to evaluate the patients' cardiac structures and functions. Results The plasma NT-BNP level in Group 1 was significantly higher than those in Group 2 and Group 3 and increased with the severity of heart failure. There was no significant difference of plasma NT-BNP levels between Group 2 and Group 3 (p>0.05). A NT-BNP value of 102.75 pg/mL showed a sensitivity of 88.2%, a specificity of 87.5%, and an accuracy of 88.1% for diagnosing diastolic dysfunction. Patients with restrictive filling pattern on echocardiography had higher NT-BNP levels than those of impaired relaxation pattern (1961.2±304.9 versus 460.1±92.7pg/mL, p<0.001). Conclusion The elevation of plasma NT-BNP level in elderly patients with isolated diastolic dysfunction correlates with the severity of their diastolic abnormalities. The level of plasma NT-BNP has an important clinical value in the diagnosis of elderly patients with isolated diastolic dysfunction.

Prognostic Value of N-Terminal Pro-Brain Natriuretic Peptide in Acute Pulmonary Embolism

Patients with pulmonary embolism (PE) have a high risk of death and it is important to recognize factors associated with high mortality. N-Terminal pro-Brain Natriuretic Peptide (NT-pro BNP) has recently emerged as a promising biomarker for risk assessment in acute pulmonary embolism (PE). The aim of this study is to detect the in hospital prognostic value of NT-pro BNP in patients with acute (PE). Methods: This study included 64 patients diagnosed as (PE) with the mean age of 59.1 ± 16.5 years, 40 patients of them (62.5%) were male. All patients were subjected to 12 leads ECG. X-ray chest, laboratory tests including D-Dimer, troponin I, NT-pro BNP, Doppler ultrasound for the venous system of both lower limbs, Echocardiograhy and 64 multislices CT pulmonary angiography. Results: According to the admission level of NT-pro BNP our patients were divided into two groups: group I included 22 patients with normal NT-pro BNP (less than 300 pg/ml), and group II included 42 patients with elevated NT-pro BNP (more than or equal 300 pg/ml). Patients in group II were found to have a significantly higher incidence of heart failure (28.6% Vs 4.6%, p = 0.025), impaired kidney function (serum creatinine was 1.7 ± 0.6 Vs 1.1 ± 0.2, p = 0.018), tachypnea (85.7% Vs 54.5%, p = 0.006) and cardiogenic shock (26.2% Vs 0%, p = 0.014) but a significantly lower incidence of chest pain (21.4% Vs 45.5%, p = 0.04) and lower left ventricular ejection fraction (51.3% ± 16.9% Vs 67.3% ± 12.8%, p = 0.043) compared to group I. There were a significantly higher treatment with thrombolytic therapy (35.7% Vs 9.1%, p=0.021) and positive inotropics (35.71% Vs 4.55%, p = 0.006) in group II compared to group I. Also group II had a higher need for mechanical ventilation (26.12% Vs 4.55%, p = 0.04) and a longer in hospital stay (19.5 ± 10.3 Vs 5.3 ± 4.5, p = 0.001) than group I. The in hospital mortality was significantly higher in group II compared to group I (19.05% Vs 0.0%, p = 0.042). Conclusion: Elevated NT-pro BNP levels in patients with (PE) are associated with worse short term prognosis in terms of higher morbidity and mortality and it could be used as a valuable prognostic parameter and good indicator for the need of more aggressive therapy.

Effect of atorvastatin on serum oxidative stress and N-terminal brain natriuretic peptide expression in rats

Objective:To investigate the effect of atorvastatin on serum oxidative stress and N-terminal brain natriuretic peptide expression in rats.Methods:A total of 40 healthy male SD rats were randomly divided into the sham group(Croup A,n=10,saline 5 mL/d),ischemia-reperfusion group(Group B,n=10,saline S mL/d),atorvastatin group(Group C,n=10.atorvastatin 20 mg/kg·d),atorvastatin + N-amino-arginine group(Group D,n=10,atorvastatin 20 mg/kg·d + N-amino arginine 15 mg/kg).Myocardial ischemia-reperfusion rat model was eslablished after 3 days of gavage.N-amino arginine 15 mg/kg was given by tail vein injection 15 min before ischemia.After reperfusion,enzymology indicators such us creatine kinase(CK) and lactate dehydrogenase and the oxidative stress parameters such as nitric oxide(NO),malondialdehyde(MDA) and total superoxide dismutase(TSOD),and n-terminal pro-brain natriuretic peptide(NT-proBNP)expression was detected by immunohistochemistry.Results:LDH and CK levels of group A were significantly lower than the outer three groups,and group B was the highest.There was significant difference between group B and group C(P<0.05),and no significant difference between group B and group D(P>0.05).MDA levels in group B were significantly higher than the other three groups.The lowest was group A,followed by group C,the difference among groups was significantly(P<0.05).TSOD and NO levels in group B was the lowest,the level in group A was the highest,followed by group C,the difference among groups was significant(P<0.05).NT-proBNP level in group B was significantly higher than the other three groups,the lowest was group A,followed by group C,the difference among groups was significant(P<0.05).Conclusions:Atorvastatin has a protective effect on the myocardial injury in the myocardial ischemia and reperfusion rats.It can increase NO synthesis and decrease MDA content,increase serum TSOD activity and the oxidative stress effect,meanwhile protect myocardial cells and reduce myocardial injury.

Value of N-Terminal Pro B-Type Natriuretic Peptide,High-Sensitivity C-Reactive Protein,and Homocysteine Levels in Predicting Cardiovascular Events in Chronic Heart Failure Patients After Discharge

Objective:To investigate the value of N-terminal pro B-type natriuretic peptide(NT-proBNP),high-sensitivity C-reactive protein(hs-CRP),and homocysteine(Hcy)levels in predicting cardiovascular events(CV)in patients with chronic heart failure(CHF).Methods:A total of 63 patients with CHF admitted to our hospital between June 2019 and July 2021 were selected.Their NT-proBNP,hs-CRP,and Hcy levels were detected at discharge,and a 12-month follow-up was done after their discharge to collect clinical data.The collected data were inclusive of data from 21 CHF patients with cardiovascular disease and 42 CHF patients without cardiovascular disease.The effect of NT-proBNP,hs-CRP,and Hcy levels on the occurrence of CV was analyzed.Results:The levels of NT-proBNP,hs-CRP,and Hcy in the group with cardiovascular disease were significantly higher than those in the group without cardiovascular disease(P<0.05);the levels of serum NT-proBNP,hs-CRP,and Hcy at discharge had certain value in predicting short-term CV in CHF patients(P<0.05).Conclusion:NT-proBNP,hs-CRP,and Hcy levels can be used to predict CV in CHF patients,thus having clinical application value.

Association of Atrial Fibrillation and Amino-terminal Pro-brain Natriuretic Peptide Concentrations in Patients After Off-Pump Coronary Artery Bypass Grafting

Objectives To investigate the possible role of amino-terminal pro-brain natriuretic peptide （NT-proBNP） in the occurrence of atrial fibrillation （AF） after coronary artery bypass grafting （CABG）. Methods This study group included 70 consecutive patients scheduled for elective off-pump CABG. The patients with ejection fraction （EF） less than 0. 30, history of AF, use of class Ⅰ or Ⅲ antiarrhythmic drug, implanted pacemaker, postoperative myocardial infarction or chest reopening for pericardial tamponade were excluded. Preoperative and postoperative serum NT-proBNP levels were measured by radioimmunoassay technique. Results Postoperative AF occurred in 15 patients （21.4%）; these patients had significantly higher median NT-proBNP levels when compared with those without AF after the operation （ P 〈 0. 01 ）. Using multivariate logistic regression analyses, an increase in NT-proBNP level after CABG was found to be independently associated with AF （ OR = 3.78, 95% IC = 1.81 - 4. 89, P 〈 0. 01 ）. Increased age, diabetes mellitus, preoperative use of β-blocker, proximal right coronary artery involvement, and longer operation time were al- so associated with AF. Conclusions These results indicated that AF was associated with higher NT-proBNP concentrations after off pump CABG; the increase in NT-proBNP after CABG may play an important role in the occurrence of AF after the operation. The further studies are needed to define the reason that lead to higher NT-proBNP concentrations among the patients who present AF after off pump CABG.

Association between plasma brain natriuretic peptide/N-terminal pro-brain natriuretic peptide levels and atrial fibrillation： evidence from a meta-analysis

Background Several small sample-size observational studies evaluated the association of plasma brain natriuretic peptide （BNP） or N-terminal pro-brain natriuretic peptide （NT-proBNP） with atrial fibrillation （AF）,but the results were contradictory.We aimed to perform a meta-analysis of relevant studies to evaluate the availability of this association.Methods We performed an extensive literature search on PubMed,Web of Science （WOS） and the Cochrane Library databases.Pooled standardized mean difference （SMD） and 95% confidence interval （CI） were calculated to assess the strength of association using random effects models.We performed sensitivity and subgroup analyses to explore the potential sources of heterogeneity.We also estimated publication biases.Statistical analyses were performed using the STATA 12.0 software.Results A total of 11 studies including 777 cases and 870 controls were finally analyzed.Overall,the brain natriuretic peptide/N-terminal pro-brain natriuretic peptide levels were higher in atrial fibrillation patients than controls without atrial fibrillation.Results showed that the SMD in the natriuretic peptide levels between cases and controls was 2.68 units （95%CI 1.76 to 3.60）; test for overall effect z-score=5.7 （P 〈0.001）.There was significant heterogeneity between individual studies （I2=97.8%; P 〈0.001）.Further analysis revealed that differences in the assay of natriuretic peptide possibly account for this heterogeneity.Conclusions Increased BNP/NT-proBNP levels were associated with the presence of atrial fibrillation.This finding indicates that BNP/NT-proBNP may prove to be a biomarker of an underlying predisposition to AF.

Association of N-terminal pro-brain natriuretic peptide with the severity of coronary artery disease in patients with normal left ventricular ejection fraction

Backround N-terminal pro-brain natriuretic peptide （NT-proBNP） is a reliable predictor in acute coronary artery disease （CAD）. Little is known about patients with stable CAD, especially Chinese patients with CAD. The aim of the present study was to investigate the association of NT-proBNP levels with the severity of CAD in patients with normal left ventricular ejection fraction. Methods A total of 658 consecutive patients were divided into two groups based on angiograms： CAD group （n=484） and angiographic normal control group （n=174）. The severity of CAD was evaluated by modified Gensini score, and its relationship with NT-proBNP was analyzed. Results The prevalence of risk factors such as age, male gender, diabetes mellitus （DM）, dyslipidemia, smoking, and family history of CAD in the CAD group were higher than that in the control group. In multivariate regression model analysis, age, gender, and DM were determinants of the presence of CAD. NT-pro BNP was found to be an independent predictor for CAD （OR：1.66 （95% CI： 1.06-2.61）, P 〈0.05）. In a receiver operating characteristic （ROC）curve analysis, an NT-proBNP value of 641.15 pmol/L was identified as a cut-off value in the diagnosis or exclusion of CAD （area under curve （AUC）=0.56, 95% CI： 0.51-0.61）. Furthermore, NT-proBNP was positively correlated with Gensini score （r=0.14, P 〈0.001） in patients with CAD. Conclusion NT-proBNP was an independent predictor for Chinese patients with CAD, suggesting that the NT-proBNP level might be associated with the presence and the severity of CAD.

Predictive value of N-terminal pro-brain natriuretic peptide in combination with the sequential organ failure assessment score in sepsis

Background The prognostic power of n-terminal pro-brain natriuretic peptide （NT-proBNP） in sepsis is disputable and unstable among different models. We attempt to evaluate the prognostic potential of NT-proBNP in combination with the sequential organ failure assessment （SOFA） score in sepsis. Methods In this retrospective study, 100 consecutive sepsis patients were enrolled. Clinical data such as admission SOFA, the Acute Physiologic and Chronic Health Evaluation score, shock prevalence, use of lung protective ventilation, vasopressors, and glucocorticoids were recorded. Additionally, serum creatinine （Scrl and Scr3） and NT-proBNP （NT-proBNP1 and NT-proBNP3） were assayed and evaluated at admission and on day 3 respectively. Results ANT-proBNP （NT-proBNP3 minus NT-proBNP1） （P 〈0.001, Hazard ratio （HR）=1.245, 95% confidence interval （CI）, 1.137-1.362） and admission SOFA （P 〈0.001, HR=1.197, 95% CI, 1.106-1.295） were independently related to in-hospital mortality. Their combination was a more robust predictor for in-hospital mortality than either of them individually. Patients with high ANT-proBNP and SOFA had the poorest prognosis. Conclusions In our study, both ANT-proBNP and SOFA were independent predictors of septic patients＇ prognosis. Moreover, the combination of ,~NT-proBNP and admission SOFA provided a novel strategy that contained information regarding both the response to treatment and sepsis severity.

Association between high-sensitivity cardiac troponin T and N-terminal pro-brain natriuretic peptide in a community based population

Background N-terminal pro-B-type natriuretic peptide （NT-proBNP） and high-sensitivity cardiac troponin T （hs-cTnT） are excellent biomarkers for detecting heart failure and subclinical myocardial injury.However,it remains unclear whether subclinical myocardial injury is associated with NT-proBNP elevation in a community based population.Methods In a community based study,levels of hs-cTnT and of NT-proBNP were determined in 1 497 participants older than 45 years.The lower detection limit of the hs-cTnT assay used in the present study was 0.003 ng/ml.The association of hs-cTnT levels and NT-proBNP levels was analyzed.Results When the subjects with undetectable （〈0.003 ng/ml）,intermediate （0.003-0.014 ng/ml）,and elevated （≥0.014 ng/ml） levels of hs-cTnT were compared （r=0.175,P 〈0.001）,a strong association between the hs-cTnT levels and NT-proBNP levels was observed （β=-0.206,P 〈0.001; β=-0.118,P 〈0.001,respectively）.In multivariable analyses,older age and hs-cTnT were positively and independently associated with NT-proBNP levels （β=0.341,P 〈0.001; β=0.143,P 〈0.001,respectively）,and male gender and the levels of eGFR were inversely and independently associated with NT-proBNP levels.When the subjects with normal or elevated NT-proBNP were analyzed separately,the hs-cTnT level was not an independent predictor for the NT-proBNP level in the normal NT-proBNP group,whereas the hs-cTnT level was the only independent predictor for NT-proBNP level in the elevated NT-proBNP group （β=0.399,P 〈0.01）.Conclusions In this community based population,NT-proBNP elevation was common.In addition to female gender and older age,subclinical myocardial injury indicated by the hs-cTnT level was another important factor in NT-proBNP elevation.

Plasma N-terminal pro-Brain natriuretic peptide levels after hybrid therapy with pulmonary vein isolation and amiodarone for atrial fibrillation

Background The purpose of this study was to investigate the effect of hybrid therapy and the relationship between the plasma N-terminal pro-Brain natriuretic peptide （NT-pro BNP） levels and the recurrence rate of the atrial fibrillation （AF） patients underwent pulmonary vein isolation （PVI） with or without amiodarone. Methods There were two groups in this study： control group and hybrid group. In the control group, 54 patients （36 males, 54±13 years） including paroxysmal （PAF） 22, persistent （Pers-AF） 15, and permanent AF （perm-AF） 17, respectively, underwent the PVI procedure only; In the hybrid, 63 AF patients （41 males, 53±12 years） including PAF 24, Pers-AF 18, and perm-AF 21, respectively,underwent the PVI procedure and used amiodarone to enhance the effect of PVI. Blood samples were collected before and 3 months after PVI. NT-pro BNP concentrations were determined by immunoassays. Results In the control group, AF recurred in 29 patients （PAF 5 in 22, Pers-AF 11 in 15, and perm-AF 13 in 17） after the initial PVI procedure; And in the hybrid group, AF recurrred in 20 patiens （PAF 3 in 24, Pers-AF 7 in 18, and perm-Af 11 in 21 ）. The average recurrent rate decreased significantly in the hybrid group （53.7% vs 31.7%, P0.01）. While the NT pro- BNP level （pg/mL） was significantly different between the 2 groups （PAF 294.34±54.4 versus 241.69±17.6 pg/mL, P=0.047; Pers-AF 487.51±47.9 versus 248.76±19.4, P=0.001; Perm-AF 490.91±38.3 versus 300.86±31.8, P=0.032）, While the NT pro- BNP level was also much lower in hybird group than control group in total （263.43±26.1 versus 409.88±49.7, P=0.02）. Conclusions Sinus rhythm（SR）following AF ablation is associated with a dramatic decrease in NT-pro BNP. The hybrid group which had the administration of amiodarone after PVI would significantly decrease the plama NT pro-BNP levels and the recurrent rate of AF.

Decrease of plasma N-terminal pro p-type natriuretic peptide as a predictor of clinical improvement after cardiac resynchronization therapy for heart failure

Background N-terminal pro β-type natriuretic peptide （NT pro BNP） has been shown to predict the prognosis and could guide the treatment of heart failure. We aimed to investigate the values of NT pro BNP in predicting the clinical response to cardiac resynchronization therapy （CRT）. Methods A total of 44 patients with chronic heart failure （34 male and 10 female, mean age of （58±13） years, New York Heart Association （NYHA） class 3.3±0.5, QRS duration （150±14） milliseconds） who underwent successful implantation of a CRT system were enrolled in this study. Pharmacotherapy remained stable during the first 3 months of follow-up. Plasma levels of NT pro BNP were evaluated before and 3 months after implantation. Clinical, echocardiographic and exercise parameters were monitored at each clinical visit after CRT implantation. Receiver operating characteristic analysis and a paired ttest were performed to analyze the data. Results After a mean of （16.3±5.5） months of follow-up, 11 nonresponders were identified. CRT resulted in a significant reduction in NT pro BNP （（1.70±1.28） vs （1.07±0.88） pmol/ml, P 〈0.001） in responders. Percentage change in NT pro BNP level （△BNP%） was a statistically significant predictor of long term clinical improvement at 3 months of follow-up. Conclusions △BNP% from baseline to 3 months of follow-up is a predictor of long term response to CRT. NT pro BNP may be a simple method for monitoring the effects of CRT.

超高N-末端脑利钠肽值(NT-pro BNP)和心率震荡(HRT)对心衰患者临床价值的分析

目的:测定老年慢性心衰患者的血浆N-末端脑钠素前体(NT-pro BNP)和心率震荡(HRT)水平,探讨血浆NTPro BNP和HRT值对心衰的临床价值的评估。方法:选择本院住院心力衰竭(CHF)的住院患者80例组成,其中男、女比例不限;对照组80例,为心功能正常者。两组年龄、性别差异无显著意义(P>0.05),具有可比性。心衰患者测定NT-pro BNP>5 000pg/ml和TS≤3.0的患者。分为好转组和死亡组。随访1年。两组比较分析。结果:老年CHF患者与老年健康者NT-pro BNP、窦性HRT存在明显差别(P<0.05);老年CHF组NT-pro BNP(4 967.04±366.16)pg/ml明显高于对照组(416.21±146.54)pg/ml(P<0.001);老年CHF组TO(0.76±3.42)明显高于对照组(-1.61±2.05)(P<0.05);老年CHF组TS(2.53±1.21)明显低于对照组(9.56±4.03)(P<0.05)。老年CHF组LVEF(38.37±12.15)%明显低于对照组的(66.52±13.05)%(P<0.05)。结论:慢性心衰患者的NT-pro BNP>5000pg/ml和TS≤3.0死亡率高。

血清NT-proBNP和Galectin-3水平对急性缺血性脑卒中患者预后的影响

目的探讨血清N末端脑钠肽前体(NT-proBNP)和半乳糖凝集素-3(Galectin-3)水平对急性缺血性脑卒中(AIS)患者预后的影响。方法选取2018年2月-2019年4月郑州市某医院诊治的76例AIS患者为研究对象,按病情程度分为2个亚组(轻度组与重度组),并取同期76例体检健康者作为对照组。比较3组研究对象的血清NT-proBNP和Galectin-3水平。按照患者的改良Rankin(mRS)评分将患者分为预后良好组与预后不良组,比较2组患者血清NT-proBNP和Galectin-3水平,并分析其与患者预后的相关性。结果重度组NT-proBNP和Galectin-3水平明显高于轻度组与对照组,轻度组明显高于对照组,差异均有统计学意义(P<0.05)。预后良好组患者NT-proBNP和Galectin-3水平明显低于预后不良组,差异均有统计学意义(P<0.05)。经相关性分析发现,AIS患者NT-proBNP和Galectin-3水平与mRS评分呈正相关(r=0.892、0.987;P<0.05)。结论病情越重、预后越差AIS患者的NT-proBNP、Galectin-3水平越高,联合这2项指标的检测能为AIS的临床诊治及预后评估提供参考。

H-FABP、NT-proBNP与急性心力衰竭患者容量负荷状态及预后的相关性

目的 研究心型脂肪酸结合蛋白(H-FABP)、氨基端脑钠肽前体(NT-proBNP)对急性心力衰竭患者容量负荷状态及预后的评估。方法 本研究为前瞻性研究,以2021年1月至2022年1月于安阳市人民医院急诊住院的老年急性心力衰竭患者83例作为研究组,另选取83例健康者作为对照组。根据相对容量平衡水平,将以上83例患者分为容量超负荷组和非容量超负荷组,对所有出院患者随访3个月,将发生死亡的患者归为死亡组,其余为生存组。比较研究组与对照组不同容量负荷、不同预后的H-FABP、NT-proBNP水平之间的差异,研究H-FABP、NT-proBNP与生存状况以及容量负荷状态的相关性。结果 研究组患者的H-FABP、NT-proBNP水平高于对照组(P<0.001);容量超负荷组患者的H-FABP、NT-proBNP水平高于非容量超负荷组(P<0.05);死亡组患者的H-FABP、NT-proBNP水平高于生存组(P<0.05)。通过相关性分析,患者的死亡以及容量超负荷与H-FABP、NT-proBNP呈现正相关(P<0.001)。结论 H-FABP、NT-proBNP与急性心力衰竭患者容量负荷状态及预后呈现相关性,有助于评估急性心力衰竭的严重程度,对预后不良患者起到积极的指导治疗作用。

NT-pro BNP、Hcy及Apo-A与急性心肌梗死患者心力衰竭程度及预后的相关性

目的:探究N-末端脑钠肽前体(NT-pro BNP)、同型半胱氨酸(Hcy)及载脂蛋白A(Apo-A)与急性心肌梗死(AMI)患者心力衰竭(HF)程度及预后的相关性。方法:选择我院2021年1月至2023年12月收治的100例AMI患者作为研究对象,按有无合并HF设为HF组(n=44)与非HF组(n=56)。检测全部患者血清NT-pro BNP、Hcy及Apo-A水平,以Killip分级评估HF组患者HF程度,将HF组患者按预后情况分为预后良好组(n=24)与预后不良组(n=20)。采用单因素及多因素分析影响AMI患者预后不良的因素,并采用受试者工作曲线(ROC)分析血清NT-pro BNP、Hcy及Apo-A水平预测AMI合并HF患者预后的价值。结果:HF组患者血清NT-pro BNP、Hcy及Apo-A水平高于非HF组(P<0.05)。HFⅣ级组患者血清NT-pro BNP、Hcy及Apo-A水平高于Ⅲ级组、Ⅱ级组,且Ⅲ级组高于Ⅱ级组(P<0.05)。经Spearson相关性分析显示,血清NT-pro BNP、Hcy及Apo-A水平与HF程度均呈正相关(r=0.612、0.505、0.649,P<0.05)。预后良好组与预后不良组患者年龄、高脂血症史、心界扩大、NT-pro BNP、Hcy及Apo-A水平比较,差异有统计学意义(P<0.05)。Logistic回归分析显示,年龄、NT-pro BNP、Hcy及Apo-A为AMI合并HF患者预后的影响因素(P<0.05)。血清NT-pro BNP水平预测水平AMI合并HF患者预后的AUC为0.769(0.617~0.882),灵敏度75.00%,特异度79.17%(P<0.05);血清Hcy水平预测AMI合并HF患者预后的AUC为0.833(0.690~0.928),灵敏度95.00%,特异度58.33%(P<0.05);血清Apo-A水平预测AMI合并HF患者预后的AUC为0.877(0.743~0.957),灵敏度85.00%,特异度91.67%(P<0.05)。结论:血清NT-pro BNP、Hcy及Apo-A水平随AMI患者HF级别递增而上升,且与患者预后密切相关,具有较高预测价值。

冻干重组人脑利钠肽对缺血性心肌病心力衰竭患者NT⁃proBNP、AngⅡ、NE水平、心室重构和炎症因子的影响

目的探讨缺血性心肌病(ICM)心力衰竭(HF)患者应用冻干重组人脑利钠肽治疗对N末端脑钠肽前体(NT⁃proBNP)、血管紧张素Ⅱ(AngⅡ)、去甲肾上腺素(NE)水平、心室重构和炎症因子的影响。方法于2020年10月至2023年2月从宿松县人民医院选择86例ICM HF患者分为对照组和试验组,均43例,以随机数字表法分组。对照组和试验组分别予以常规治疗和冻干重组人脑利钠肽联合常规治疗,均治疗2周。比较两组疗效(治疗2周后)、血清NT⁃proBNP、AngⅡ、NE、心室重构指标和炎症因子水平(治疗前和治疗2周后)。结果治疗2周后,较对照组(74.42%),试验组总有效率(93.02%)更高,差异有统计学意义(χ^(2)=5.460,P<0.05)。两组治疗2周后的血清NT⁃proBNP、AngⅡ、NE、TNF⁃α、IL⁃6、IL⁃8和LVTWP、PWS、IVSS较治疗前降低,试验组更低,差异有统计学意义(t=5.672、20.016、55.416、6.742、5.851、5.258、5.940、6.681、5.865,P<0.05)。结论ICM HF患者应用冻干重组人脑利钠肽治疗可降低血清NT⁃proBNP、AngⅡ、NE水平,改善神经分泌功能,同时可抑制心室重构及机体炎症,疗效显著。

血清D-二聚体与纤维蛋白原比值联合血清NT-proBNP水平对急性肺栓塞患者预后的预测价值

目的探讨血清D-二聚体/纤维蛋白原比值(DFR)联合N末端脑钠肽前体(NT-proBNP)对急性肺栓塞患者预后的预测价值。方法采用回顾性研究,将2019年1月至2022年12月河北北方学院附属第一医院收治的急性肺栓塞患者作为研究对象。共入组108例患者,按30 d预后情况将其分为死亡组(n=29)与存活组(n=79)。比较两组血清D-二聚体、纤维蛋白原、DFR、NT-proBNP水平等临床资料差异;采用多因素Logistic回归分析影响急性肺栓塞患者预后的因素;采用受试者操作特征(ROC)曲线评定血清DFR、NT-proBNP水平对急性肺栓塞患者预后的价值。结果死亡组年龄为(72.87±11.25)岁,大于存活组[(66.47±12.46)岁],差异有统计学意义(P<0.05),两组其他一般资料比较,差异均无统计学意义(P>0.05)。死亡组的血清hs-CRP、D-二聚体、纤维蛋白原、DFR及NT-proBNP水平分别为(4.51±1.36)mg/L、(1.05±0.29)mg/L、(5.14±1.21)g/L、0.25±0.08、(2084.51±619.74)ng/L,均高于存活组[(3.84±1.21)mg/L、(0.81±0.22)mg/L、(4.54±0.78)g/L、0.18±0.05、(1547.46±413.69)ng/L],差异均有统计学意义(P<0.05);两组白细胞、中性粒细胞等比较,差异均无统计学意义(P>0.05)。Logistic回归分析,得出年龄较大、较高DFR及NT-proBNP水平是急性肺栓塞患者30 d死亡的危险因素(OR=2.389,95%CI:1.194~4.782;OR=1.906,95%CI:1.236~2.939;OR=1.610,95%CI:1.129~2.295;P<0.05)。ROC曲线分析得出,血清DFR、NT-proBNP均对急性肺栓塞患者30 d死亡有一定预测能力,其AUC分别为0.828、0.763,二者联合的AUC达到0.907。结论血清DFR、NT-proBNP水平与急性肺栓塞患者30 d预后相关,均可作为患者30 d死亡的预测标志物。

慢性心力衰竭患者白蛋白降低与NT-proBNP升高和长期预后不良的相关性分析

目的分析慢性心力衰竭(CHF)患者白蛋白降低与N末端脑钠肽前体(NT-proBNP)升高和长期预后不良的相关性。方法选取2020年3月至2022年3月于安徽医科大学心血管内科及全科医学科CHF住院患者176例,根据白蛋白中位数分为高白蛋白组96例和低白蛋白组80例,比较两组患者的临床资料,Spearman分析白蛋白和NT-proBNP的相关性,计算2年内全因再住院和全因死亡率的累计发生率和发病密度,Cox分析白蛋白对2年内全因再住院和全因死亡率的影响。结果患者白蛋白中位数为37.16 g/L,高白蛋白组体质指数(BMI)和白蛋白水平高于低白蛋白组,NT-proBNP水平低于低白蛋白组,白蛋白与NT-proBNP-log10转换呈负相关(r=-0.217,P<0.001)。低白蛋白组全因死亡和全因再住院的发病密度和累计发病率均高于高白蛋白组。白蛋白降低是CHF患者全因再住院和全因死亡率增加的相关因素,且不受性别、心功能、NT-proBNP和β受体阻滞剂的影响。结论CHF患者白蛋白降低与NT-proBNP升高和长期预后不良有关,临床需对CHF患者的营养状况给予足够的关注。

LDH、NT-proBNP、ALB水平对不完全性川崎病的早期诊断价值

目的:探讨乳酸脱氢酶(LDH)、N末端脑钠肽前体(NT-proBNP)、白蛋白(ALB)水平对不完全性川崎病(IKD)的早期诊断价值。方法:选取巴彦淖尔市医院2020年1月—2023年1月收治的80例IKD患儿作为IKD组,选取本院同期收治的80例典型川崎病(KD)患儿作为KD组。所有患儿入院后检测LDH、NT-proBNP、ALB水平,对比IKD组与KD组一般情况和LDH、NT-proBNP、ALB水平。通过受试者操作特征(ROC)曲线分析LDH、NT-proBNP、ALB水平对IKD的早期诊断价值。同时将80例IKD患儿依照冠脉损伤情况分为两个亚组,即无损伤组(n=30)和损伤组(n=50),对比两组LDH、NT-proBNP、ALB水平。结果:IKD组和KD组性别、年龄及高热、多形性皮疹、口腔黏膜变化占比对比,差异均无统计学意义(P>0.05);IKD组发热时间长于KD组,指端改变、结膜充血、颈部淋巴结肿大占比低于KD组,差异均有统计学意义(P<0.05);IKD组LDH、NT-proBNP、ALB水平均明显高于KD组,差异均有统计学意义(P<0.05);LDH、NT-proBNP、ALB三者联合对IKD的诊断效能优于单一检测;损伤组LDH、NT-proBNP、ALB水平均明显高于无损伤组,差异均有统计学意义(P<0.05)。结论:LDH、NT-proBNP、ALB水平对IKD的早期诊断价值较高,且临床可考虑通过LDH、NT-proBNP、ALB三者联合来诊断IKD。

血浆NT-proBNP和Cys-C在诊断早产儿支气管肺发育不良合并肺动脉高压中的应用价值

目的:探讨血浆氨基末端脑钠肽前体(NT-proBNP)和胱抑素C(Cys-C)在诊断早产儿支气管肺发育不良(BPD)合并肺动脉高压(PH)中的应用价值。方法:选取2021年6月至2022年12月在江西省妇幼保健院NICU住院治疗的BPD早产儿,将其中合并PH的患儿设为试验组(27例),随机选择未合并PH者设为对照组(36例)。收集所有患儿的血浆NT-proBNP和Cys-C水平进行对比分析,并总结血浆NTproBNP和Cys-C水平对BPD合并PH的预测价值。结果:试验组出生后7 d和14 d的血浆NT-proBNP水平均显著高于对照组(P<0.001),而Cys-C水平则显著低于对照组(P<0.001)。通过受试者工作特征(ROC)曲线分析显示,出生后14 d血浆NT-proBNP水平预测早产儿BPD合并PH的最佳截断值为357.39 pg/mL,曲线下面积(AUC)为0.958,灵敏度为92.59%,特异度为91.67%,最大约登指数为0.843;出生后7 d Cys-C水平预测早产儿BPD合并PH的最佳截断值为1.41 mg/L,AUC为0.858,灵敏度为77.78%,特异度为87.30%,最大约登指数为0.722。结论:血浆NT-proBNP和Cys-C对于诊断早产儿BPD合并PH具有较高的价值,可作为评估病情严重程度和预测预后的有效指标。