摘要
目的探讨老年心衰患者N末端脑钠肽前体(NT-pro BNP)、血清同型半胱氨酸(Hcy)、Lorenz散点图与心功能相关性及对预后的预测价值。方法选取2022年4月至2024年3月青岛大学附属泰安市中心医院老年心血管科心衰患者47例为心衰组,另选取同期住院非心衰患者47例为对照组。所有患者检测NT-pro BNP、Hcy、24h动态心电图获得心律失常类型及Lorenz散点图、心脏彩超检查获得左室射血分数(LVEF);比较两组NTpro BNP、Hcy、心律失常类型及发生率、Lorenz散点图分布特点、LVEF水平,并分析相关性。结果心衰组NTpro BNP水平高于对照组;心衰组LVEF水平低于对照组(P<0.01),两组Hcy差异无统计学意义(P>0.05);心衰组Lorenz散点图以扇状图及不规则形状为主,对照组以棒球拍型为主,差异有统计学意义(P<0.05);心衰组房颤发生率及心电图ST-T异常发生率高于对照组(P<0.05);心衰组再住院率高于对照组(23.40%vs.14.89%),但差异不显著(P>0.05)。ROC曲线显示血清NT-pro BNP对射血分数减低心衰曲线下面积(AUC)为0.876923,Hcy对射血分数减低心衰AUC为0.723104;Pearson相关性分析显示,NT-pro BNP与LVEF呈负相关(r=-0.544),Hcy与LVEF呈正相关(r=0.199),Lorenz散点图(扇形图及不规则形图)与LVEF呈负相关(r=-0.221)。结论NT-pro BNP、HCY、Lorenz散点图三项指标均与心功能相关,具有潜在的联合应用价值,尤其射血分数减低心衰患者有较高的预测价值,并可评估患者的预后。
Objective To investigate the correlation between N-terminal pro-brain natriuretic peptide(NT-pro BNP),serum homocysteine(Hcy),Lorenz scatter plot,and cardiac function in elderly patients with heart failure,as well as their predictive value for prognosis.Methods A total of 47 heart failure patients admitted to the Department of Geriatric Cardiology of Qingdao University Affiliated Taian Central Hospital from April 2022 to March 2024 were selected as the heart failure group,and another 47 non-heart failure patients hospitalized during the same period were selected as the control group.All patients underwent testing for NT-pro BNP and Hcy,24-hour dynamic electrocardiogram to obtain arrhythmia types and Lorenz scatter plot,and cardiac ultrasound to obtain left ventricular ejection fraction(LVEF).The levels of NT-pro BNP,Hcy,types and incidence of arrhythmia,distribution characteristics of Lorenz scatter plot,and LVEF were compared between the two groups,and their correlations were analyzed.Results The NT-pro BNP level in the heart failure group was higher than that in the control group;the LVEF level in the heart failure group was lower than that in the control group(P<0.01).There was no significant difference in Hcy between the two groups(P>0.05).The Lorenz scatter plot in the heart failure group was mainly fan-shaped and irregular,while that in the control group was mainly baseball bat-shaped,with a statistically significant difference(P<0.05).The incidence of atrial fibrillation and ST-T abnormalities on electrocardiogram in the heart failure group was higher than that in the control group(P<0.05).The readmission rate in the heart failure group was higher than that in the control group(23.40%vs.14.89%),but the difference was not significant(P>0.05).ROC curve analysis showed that the area under the curve(AUC)of serum NT-pro BNP for predicting heart failure with reduced ejection fraction was 0.876923,and the AUC of Hcy for predicting heart failure with reduced ejection fraction was 0.723104.Pearson correlation analysis showed that NT-pro BNP was negatively correlated with LVEF(r=-0.544),Hcy was positively correlated with LVEF(r=0.199),and Lorenz scatter plot(fan-shaped and irregular patterns)was negatively correlated with LVEF(r=-0.221).Conclusion NT-pro BNP,Hcy,and Lorenz scatter plot are all correlated with cardiac function and have potential value for combined application,especially in predicting heart failure with reduced ejection fraction and evaluating patient prognosis.
作者
陈梅
侯存强
王晓
CHEN Mei;HOU Cunqiang;WANG Xiao(Department of Geriatric Cardiology,Taian Central Hospital,Affiliated to Qingdao University,Taian 271000,China;Department of Orthopedics,Taian 88 Hospital,Taian 271000,China;Department of Geriatric Pulmonology,Taian Central Hospital,Affiliated to Qingdao University,Taian 271000,China)
出处
《中华灾害救援医学》
2025年第7期765-770,共6页
Chinese Journal of Disaster Medicine
基金
青岛大学附属泰安市中心医院苗圃培育项目(2022MP20)。
关键词
心衰
相关性
预后
Heart failure
Correlation
Prognosis
