| 摘要: |
| 摘 要 目的 探讨超声心动图、NT-pro BNP对肺心病患者预后判断的价值。 方法 将152例肺心病患者根据右心室功能分为右心代偿组和失代偿组，比较两组入院、出院时超声心动图和NT-pro BNP的变化，随访1年时的不良心血管事件发生情况，应用Kaplan-Meier生存分析评价两组的生存情况、Logistic回归分析1年不良心血管事件的危险因素、受试者工作特征性曲线评估相应的敏感性和特异性。结果 经过治疗代偿组患者的NT-pro BNP、右心室舒张末期内径、肺动脉压及右心室功能指标较失代偿组均有所改善（P<0.05）。随访1年，代偿组发生30例不良心血管事件，失代偿组46例。Kaplan-Meier生存分析两组间的中位生存时间有显著差别（P<0.05）。ROC曲线显示NT-pro BNP>1548.6 pg/mL预测患者1年不良心血管事件的敏感性为78.3%，特异性为76.4%；肺动脉压>67.3 mmHg预测1年不良心血管事件的敏感性为60.1%，特异性为55.3%；将NT-pro BNP与肺动脉压二者结合，其敏感性为88.4%，特异性为81.5%。结论 肺心病右心功能失代偿组患者预后差，NT-pro BNP、肺动脉收缩压可以作为预测患者1年不良心血管事件发生的因素。 |
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| DOI： |
| 投稿时间：2017-09-26修订日期：2018-02-09 |
| 基金项目:中国石油华北油田科技项目(2017-HB-G0904) |
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| Effect of echocardiography and NT-pro BNP for predicting adverse cardiac events in patients with pulmonary heart disease |
| LIU Hong-lei |
| (Department of Functional Inspection,North China Hospital of University of Chinese Academy of Sciences) |
| Abstract: |
| Abstract Objective To explore the value of echocardiography and NT-pro BNP for predicting adverse cardiac events in patients with pulmonary heart disease. Methods According to the right ventricular function 152 patients with pulmonary heart disease patients were divided into compensatory group and decompensatory group.We compared the changes of cardiac function and NT-pro BNP etc between the two groups, follow up the risk factors for adverse cardiac events after 1 year. Furthermore, we used the Kaplan-Meier survival analysis to evaluate the survival benefit, Logistic regression to evaluate the risk factors for 1 year adverse cardiac events and receptor-operating characteristic (ROC) curves for sensitivity and specificity. Result NT-pro BNP, right ventricular function index, right ventricular end-diastolic diameter and pulmonary systolic pressure were also markedly different between the groups (P < 0.05). At 1-year follow-up, 30 compensatory group patients and 46 decompensatory group patients had adverse cardiac events,Kaplan-Meier analysis showed significant survival duration between groups (P < 0.05). ROC curve showed that NT-pro BNP (1547.6 pg/mL, sensitivity 78.3%, specificity 76.4%) and pulmonary systolic pressure (67.3 mmHg, sensitivity 60.1%, specificity 55.3%) were predictors. Combining NT-pro BNP with pulmonary systolic pressure, the sensitivity was 88.4% and the specificity was 81.5%.Conclusion Pulmonary heart disease patients with decompensatory right ventricle was associated with worse prognosis. NT-pro BNP and pulmonary systolic pressure were predictors of short-term adverse cardiac events risk. |
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