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目的:探讨冠心病心力衰竭患者颈股搏波传导速度(cfPWV)及血清脑钠肽(BNP)水平与冠状动脉病变程度的相关性及其对患者预后的预测价值。方法:选择冠心病心力衰竭患者90例,依据心脏彩超EF值分别分为三组,A组(EF值>40%),B组(30%0.05)。C组的cfPWV明显快于A、B两组,存在显著性差异(P<0.05),A、B组间无统计学差异(P>0.05)。三组间收缩压、Gensini积分和血清BNP水平比较存在统计学差异(P<0.05)。A、B组间脉压比较无统计学差异(P>0.05),C组与A组、B组脉压比较均存在统计学差异(P<0.05)。CfPWV与血清BNP水平、Gensini积分呈正相关。cfPWV对冠心病心力衰竭患者预后的ROC曲线下面积为0.617,其预测冠心病心力衰竭患者发生不良事件的灵敏度为81.8%,特异性为60.9%;血清BNP水平对冠心病心力衰竭患者预后的ROC曲线下面积为0.767,其预测冠心病心力衰竭患者发生不良事件的灵敏度为93.2%,特异性为56.5%。结论:cfPWV与血清BNP水平、冠状动脉病变程度之间具有相关性,cfPWV对冠心病心力衰竭患者发生不良事件具有中等的预测价值,但其敏感性及特异性有限。
Objective: To investigate the correlation between the level of cfPWV and BNP in patients with coronary heart disease and coronary artery disease and its prognostic value. Methods: Ninety patients with heart failure of coronary heart disease were divided into three groups according to the echocardiographic EF value: group A (EF> 40%), group B (30% 0.05). The cfPWV in group C was significantly faster than that in group A and B (P <0.05). There was no significant difference between group A and B (P> 0.05). Systolic blood pressure, Gensini score and serum BNP levels were significantly different among the three groups (P <0.05). There was no significant difference in pulse pressure between groups A and B (P> 0.05). There was significant difference in pulse pressure between group C and groups A and B (P <0.05). CfPWV and serum BNP levels, Gensini score was positively correlated. The area under the ROC curve of CFPWV for prognosis of CHD patients with heart failure was 0.617, which predicted the incidence of adverse events in patients with CHD was 81.8% with specificity of 60.9%. The serum BNP level had no significant difference between the two groups The area under the curve was 0.767, which was 93.2% predictive of adverse events in patients with heart failure and 56.5% specificity. CONCLUSIONS: There is a correlation between cfPWV and serum BNP levels and the degree of coronary artery lesions. CFPWV has moderate predictive value for adverse events in patients with coronary heart disease and heart failure, but its sensitivity and specificity are limited.