血清脑钠肽、D-二聚体、心功能指标水平与慢性心力衰竭患者病情程度及远期死亡结局的关系分析
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樟树市人民医院

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Analysis of relationship between serum brain natriuretic peptide, D-dimer, cardiac function indicators and disease severity and long-term death outcome in patients with chronic heart failure
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    目的:探讨血清脑钠肽(BNP)、D-二聚体(D-D)、心功能指标水平与慢性心力衰竭患者病情程度的关系及预测远期死亡结局的价值。方法:参照美国纽约心脏病协会(NYHA)的心功能分级对我院在2021年2月~2024年3月期间就诊的60例慢性心力衰竭患者进行分组,其中20例心功能Ⅱ级患者为轻度组、27例心功能Ⅲ级患者为中度组以及13例心功能Ⅳ级患者为重度组。再将60例慢性心力衰竭患者根据1年内是否死亡分为发生组(n=17),未发生组(n=43),比较各组患者血清BNP、D-D、乳酸脱氢酶(LDH)水平。最后关于血清BNP、D-D、LDH水平对慢性心力衰竭患者远期死亡结局的预测价值采用受试者工作特征(ROC)曲线进行分析。结果:与轻度组相比,中重度组患者血清BNP、D-D、LDH水平均更高,且重度组高于中度组(P<0.05)。相较于未发射组,发生组患者血清BNP、D-D、LDH水平均较高(P<0.05)。BNP、D-D、LDH水平预测慢性心力衰竭患者死亡的效能均较高(P<0.001),曲线下面积(AUC)分别为0.777、0.858、0.839,敏感度分别为88.27%、70.59%、60.47%,特异度分别为82.35%、97.67%、76.74%。结论:BNP、D-D、LDH水平与慢性心力衰竭患者病情程度呈正相关,且三项指标能够对患者远期死亡结局进行预测,BNP、D-D、LDH水平越高提示患者远期死亡风险越高。

    Abstract:

    Objective: To investigate the relationship of serum brain natriuretic peptide (BNP), D-dimer (D-D) and cardiac function indicators with disease severity in patients with chronic heart failure and the value on predicting long-term death outcome. Methods: Referencing to the New York Heart Association (NYHA) cardiac function grading, 60 patients with chronic heart failure in the hospital from February 2021 to March 2024 were grouped, 20 cases with cardiac function grade II were set as mild group, and 27 cases with cardiac function grade III were enrolled as moderate group, and 13 cases with cardiac function grade IV were included in severe group. 60 patients with chronic heart failure were classified into occurrence group (n=17) and non-occurrence group (n=43) according to whether they died within 1 year. The levels of serum BNP, D-D and lactate dehydrogenase (LDH) in each group were compared. The predictive value of serum BNP, D-D and LDH levels on long-term death in patients with chronic heart failure was discussed by receiver operating characteristic (ROC) curve. Results: Compared with mild group, the levels of serum BNP, D-D and LDH in moderate and severe groups were higher, and the levels were higher in severe group compared to moderate group (P<0.05). Serum BNP, D-D and LDH levels were higher in occurrence group in comparison with non-occurrence group (P<0.05). BNP, D-D and LDH had high efficiency on predicting death in patients with chronic heart failure (P<0.001), and the areas under the curves (AUCs) were 0.777, 0.858 and 0.839, and the sensitivities were 88.27%, 70.59% and 60.47%, and the specificities were 82.35%, 97.67% and 76.74% respectively. Conclusion: The levels of BNP, D-D and LDH are positively correlated with the severity of chronic heart failure, and the three indicators can predict the long-term death outcome of patients. The higher the levels of BNP, D-D and LDH are, the higher the risk of long-term death is.

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付思.血清脑钠肽、D-二聚体、心功能指标水平与慢性心力衰竭患者病情程度及远期死亡结局的关系分析[J].四川生理科学杂志,2025,47(6):

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  • 收稿日期:2025-04-15
  • 最后修改日期:2025-04-27
  • 录用日期:2025-05-07
  • 在线发布日期: 2025-06-22
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