文章摘要
唐园园,侯小锋,陈 震,王权鹏,王 垚,邹建刚.血清N-末端脑钠肽与心脏再同步化治疗慢性心衰患者预后的相关研究[J].南京医科大学学报,2015,(12):1714~1717
血清N-末端脑钠肽与心脏再同步化治疗慢性心衰患者预后的相关研究
Correlation between serum N-terminal pro-brain natriuretic peptide and prognosis of cardiac resynchronization therapy in patients with chronic heart failure
投稿时间:2015-10-23  
DOI:10.7655/NYDXBNS20151209
中文关键词: 心力衰竭  N-末端脑钠肽原  心脏再同步化治疗
英文关键词: chronic heart failure  N-terminal pro-brain natriuretic peptide  cardiac resynchronization therapy
基金项目:国家自然科学基金资助(81470457)
作者单位
唐园园 南京医科大学第一附属医院心血管内科,江苏 南京 210029
南京中医药大学附属江苏省中医院普内科,江苏 南京 210029 
侯小锋 南京医科大学第一附属医院心血管内科,江苏 南京 210029 
陈 震 南京医科大学第一附属医院心血管内科,江苏 南京 210029 
王权鹏 南京医科大学第一附属医院心血管内科,江苏 南京 210029 
王 垚 南京医科大学第一附属医院心血管内科,江苏 南京 210029 
邹建刚 南京医科大学第一附属医院心血管内科,江苏 南京 210029 
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中文摘要:
      目的:探讨术前血清N-末端脑钠肽(N-terminal pro-brain natriuretic peptide,NT-proBNP)浓度与心脏再同步化治疗(cardiac resynchronization therapy,CRT)术后慢性心衰(chronic heart failure,CHF)患者心功能以及预后的关系。方法:选择2012年3月—2014年10月在本院植入CRT或CRT-D的CHF患者60例,术前测定血浆NT-proBNP水平;术前以及术后6个月测定超声心动图测定左心室射血分数(left ventricular ejection fraction,LVEF)。依据CRT植入后6个月随访时LVEF绝对值较基线增加≥5%为标准,分为有反应组和无反应组。随访期间观察CHF患者主要不良心血管事件(major adverse cardiovascular events,MACE)。结果:CRT术后有反应组术前NT-proBNP?随访MACE发生率明显小于CRT无反应组(P < 0.01)。以NT-proBNP 2 354.5 pg/mL为最佳分界点,预测CRT术后无反应的敏感度为95.0%,特异度为92.5%。以NT-proBNP 2 254.5 pg/mL为最佳分界点,预测发生心血管事件的敏感度95.2%,特异度92.3 %。Kaplan-Meier生存曲线显示NT-proBNP≤2 254.5 pg/mL患者生存时间高于NT-proBNP≥2 254.5 pg/mL者(P < 0.01)。结论:术前血清NT-proBNP水平与CHF患者CRT术后反应程度以及心血管不良事件相关。
英文摘要:
      Objective:To investigate the correlation between preoperative plasma N-terminal pro-brain natriuretic peptide(NT-proBNP) and prognosis of cardiac resynchronization therapy as well as left ventricular function in patients with chronic heart failure.Methods:From March. 2012 to October.2014,60 patients who received CRT implantation in the first affiliated hospital,Nanjing Medical University were included. All the patients had the routine test contained NT-proBNP. Left ventricular ejection fraction(LVEF)were measured by echocardiography. The patients were divided into responders and non-responders according to whether the left ventricular ejection fraction (LVEF) increased ≥5% by 6 months. Major adverse cardiac events (MACE) was observed during follow-up. Results:Levels of NT-proBNP and MACE rates were much higher in non-responders than that in responders (P < 0.01). At the optimum cutoff point of 2 354.5 pg/mL,the sensitivity and specificity of NT-proBNP predicting CRT non-response were 95%and 92.5%,respectively.At the optimum cutoff point of 2 254.5 pg/mL,the sensitivity and specificity of NT-proBNP predicting MACE were 95.2% and 92.3%,respectively. Kaplan Meier survival curve showed the survival time in patients with BNP 2 254.5 pg/mL or less were higher than that in patients with BNP 2 254.5 pg/mL or more(P < 0.01). Conclusion:Preoperative NT-proBNP is associated with response to CRT and postoperative MACE in CHF patients.
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