•论著.NT-proBNP水平对急性心力衰竭患者近期预后的评估价值*李曼•温冬梅，王伟佳△，冯力，杜满兴，徐胜男，徐全中(中山大学附属中山医院检验医学中心，广东中山528403)摘要：目的探讨N末端脑钠肽前体(NT-proBNP)水平对急性心力衰竭(简祢急性心衰)患者近期预后的评估价值。方法选取20)541-12月接受治疗的急性心衰怒者122例作为研究对象.行常规治疗，出院后行30d随访，将发生心源性再住院及死亡情况的患赤纳入事件组.将其余患者纳入无事件组.比较两组患者在一般资料、临床表现与体征方面的差异，行多因素Logistic回归分析，观格影响患者预后的危险因素.结果随访30d后，122例患者中40例发生了终点事件。40例患者纳入事件组，82例患者的入无事件组。两组患者在年龄、性别、体质量指敬、高血压史、糖尿病史、心肌梗死史、冠心病史、房颤史方面比较，差异无统计学意义(P>0.05),无事件组患者心脏功能NYHA分级(II级占81.71%，明显高于事件组的40.00%；IV级占18.29%.明亚低于事件组的60.00%(PV0.05)。两组患者在夜间呼吸困难、主动脉蝌反流、舒张压、心率方面比较，差异无统计学意义(P>0.05)。事件组下肢水肿、肺部啰音、二尖瓣反流百分比明显高于无事件组(PV0.05)。事件组LVEDD、NT-proBNP水平明显高于无事件组.LVEF、收缩压明显低于无事件组(PV0.05)。经Logistic回归分析,NT-proBNP水平过高是急，性心衰患者近期预后不良的显著独立危险因素(OR=3.522,P=0.021,95%CJ为1.080〜4.361)。结论较高的NT-proBNP水平是急性心衰患者近期预后不良的显著危险因素。关键词：N末端脑钠肽箭体；急性心力衰竭；预后D()I：10.3969/j.issn.1672-9455.2017.12.014文献标志码：A文章编号：1672-9455(2017)12-1720-04ValueofNT-proBNPinevaluationofshort-termprognosisinpatientswithacuteheartfailure*LIMan,WENDongmei»WANGWeijia^,FENLi,DUManning,XUShengnan,XUQuanzhung(laboratoryMedicineCenter,AffiliatedZhon^shanHospital,SunYat-senUniversity,Zhongshan,Guangdong528403,C/iina)Abstract:ObjectiveToexploretheevaluationvalueofNterminalbrainnatriureticpeptide(NT-proBNP)levelontheshorttermprognosisinthepatientswithacuteheartfailure.MethodsOnehundredandtwenty-twopatientswithacuteheartfailurere-ceivingthetherapyinourhospitalfromJanuarytodecember2015wereselectedastheresearchsubjects.Allcasesweretreatedbytheroutinetherapyandfollowedupfor30d.Thecasesofre-hospitalizationduetocardiacshockanddeathwereincludedinthee-ventgroupandtheothercaseswereincludedinthenon-eventgroup.Thedifferencesintheaspectsofgeneraldata*clinicalmanifes-tationsandbodysignswerecomparedbetweenthetwogroups.ThemultivariateLogisticregressionanalysiswasperformedtoob-servetheriskfactorsinfluencingtheprognosisofthepatients.ResultsAmong122cases,theterminaleventafter30dfollowupoccurredin40cases.Sothese40caseswereincludedintheeventgroupand82caseswereincludedinthenon-eventgroup.Therewerenostatisticallysignificantdifferencesintheaspectsofage,sex,bodymassindex,historyofhypertension»historyofmyocardialinfarction.coronaryheartdiseaseandatrialfibrillationbetweenthetwogroups(P>0.05).ThecardiacfunctionNYHAgradefflinthenon-eventgroupaccountedfor81.71%,whichwassignificantlyhigherthan40.00%intheeventgroup.gradeIVaccountedfor18.29%.whichwassignificantlylowerthan60.00%intheeventgroup(P<0.05).Therewerenostatisticallysignificantdiffercnccsintheaspectsofdyspnea,aorticregurgitation.diastolicpressureandheartratebetweenthetwogroups(P>0.05).Theproportionsoflowerextremityedema,pulmonaryralesandm代ralregurgitationintheeventgroupweresignificantlyhigherthanthoseinthenon-eventgroup(PV0.05).TheLVEDDvalueandNT-proBNPleveloftheeventgroupweresignificantlyhigherthanthoseofthenon-eventgroup,whiletheLVEFvalueands...