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目的脑钠肽(BNP)主要由心室分泌的一种多肽类激素,其对国人心血管病患者近期预后评估的价值尚未确定,本研究旨在探讨脑钠肽对国人心血管病患者近期发生心源性死亡的预测价值。方法使用BIOSITETriage脑钠肽干氏快速检测方法对107例住院心血管病患者入院1～3d的脑钠肽水平进行测量,随访1月,分为存活组和死亡组。结果①存活组和死亡组脑钠肽水平差异有极显著统计学意义(U=148,P<0.0005);②血脑钠肽浓度与心率、左室舒张末期内径、心力衰竭史和心肌梗死史呈正相关(r=0.28,P=0.0004;r=0.49,P<0.0005;r=0.39,P<0.0005;r=0.21,P=0.03),与左室射血分数呈负相关(r=-0.63,P<0.0005);③脑钠肽预测1月内心源性死亡的ROC曲线下面积为0.89,95%可信区间为0.79～0.98,P<0.0005;Logistic逐步回归分析表明,惟有血脑钠肽浓度大于755pg/mL是近期心源性死亡的独立预测因子(OR=17.6,95%可信区间为8.7～66.5,P<0.0005)。结论脑钠肽对心血管病患者1月内心源性死亡的发生有极高的预测价值。
Objective BNP is secreted by the ventricular a peptide hormone, the prognosis of patients with cardiovascular disease in China has not yet determined the value of this study is to explore the role of brain natriuretic peptide in patients with recent cardiovascular disease Predictors of cardiac death. Methods The brain natriuretic peptide levels of 1 to 3 days in hospitalized patients with cardiovascular diseases were measured using BIOSITET-Prokaryotheraendodan fasting method. The patients were followed up for 1 month and divided into survival group and death group. Results ① There was a significant difference in the levels of BNP between survivors and deaths (U = 148, P <0.0005). ② The concentrations of BNP, heart rate, end-diastolic diameter, history of heart failure and history of myocardial infarction (R = -0.63, P = 0.0004; r = 0.49, P <0.0005; r = 0.39, P <0.0005; r = 0.21, P = 0.03), which was negatively correlated with left ventricular ejection fraction , P <0.0005). ③The area under the ROC curve of BNP predicted by January was 0.89 and the 95% confidence interval was 0.79 ~ 0.98, P <0.0005. Logistic regression analysis showed that only BNP Concentrations greater than 755 pg / mL were independent predictors of recent cardiac death (OR = 17.6, 95% CI 8.7 to 66.5, P <0.0005). Conclusions Brain natriuretic peptide has a very high predictive value for the occurrence of cardiogenic death in patients with cardiovascular disease in January.