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Medical Diagnosis 2025
研究NT-proBNP、ALB联合FIB与老年CHF患者预后的相关性
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Abstract:
目的：本研究旨在探讨NT-proBNP、ALB联合FIB与老年慢性心力衰竭(Chronic Heart Failure, CHF)预后相关性。方法：本研究选取了邯郸市中心医院2021年1月至2023年1月期间于心血管内科住院的120例老年慢性心力衰竭患者，收集一般临床资料、实验室资料及随访信息等。一般临床资料包括：年龄、性别、收缩压、舒张压、心率，以及既往的吸烟史；实验室资料包括：血常规、生化(FIB、ALB、LDL、HDL等)、NT-proBNP；随访资料包括：心血管不良事件的发生(恶性心律失常、急性心肌梗死、急性脑血管病等)。根据患者是否发生主要心血管不良事件(MACE)，分为MACE组和非MACE组，比较两组患者一般基线资料、主要实验室指标。通过单因素和多因素Logistic回归分析老年慢性心力衰竭患者1年内发生MACE风险，通过ROC曲线评估NT-proBNP、ALB联合FIB对老年慢性心力衰竭一年内MACE预测价值。结果：(1) 老年慢性心力衰竭患者MACE组的年龄、FIB、NT-proBNP及Cl较非MACE组高，而ALB较非MACE组低。(2) 单因素与多因素Logistic回归分析结果表明，NT-proBNP、ALB及FIB是老年慢性心力衰竭患者在一年内MACE的独立风险因素。(3) NT-proBNP、ALB联合FIB对老年CHF患者1年内MACE发生有良好的预测效果。结论：老年慢性心力衰竭1年内MACE发生率高；NT-proBNP、ALB联合FIB对老年慢性心力衰竭患者1年内MACE发生有良好的预测价值。
Objective: This study aims to explore the correlation between NT-proBNP, ALB combined with FIB and the prognosis of elderly patients with chronic heart failure (CHF). Methods: This study selected 120 elderly patients with chronic heart failure who were hospitalized in the Department of Cardiology of Hospital from January 2021 to January 2023. General clinical data, laboratory data and follow-up information were collected. General clinical data included: age, gender, systolic blood pressure, diastolic blood pressure, heart rate, and smoking history; laboratory data included: blood routine, biochemistry (FIB, ALB, LDL, HDL, etc.), NT-proBNP; follow-up data included: occurrence of adverse cardiovascular events (malignant arrhythmia, acute myocardial infarction, acute cerebrovascular disease, etc.). According to whether the patients had major adverse cardiovascular events (MACE), they were divided into MACE group and non-MACE group, and the general baseline data and main laboratory indicators of the two groups were compared. Univariate and multivariate Logistic regression analysis were used to analyze the risk of MACE in elderly patients with chronic heart failure within one year, and the predictive value of NT-proBNP, ALB combined with FIB for MACE within one year in elderly patients with chronic heart failure was evaluated by ROC curve. Results: (1) The age, FIB, NT-proBNP, and Cl of the MACE group of elderly patients with chronic heart failure were higher than those of the non-MACE group, while ALB was lower than that of the non-MACE group. (2) The results of univariate and multivariate Logistic regression analysis showed that NT-proBNP, ALB and FIB were independent risk factors for MACE within one year in elderly patients with chronic heart failure. (3) NT-proBNP, ALB
| [1] | Shrestha, J. and Done, S. (2023) An Overview of Chronic Heart Failure. Nursing Standard, 38, 43-49. https://doi.org/10.7748/ns.2023.e12049 |
| [2] | Lelonek, M., Grabowski, M., Kasprzak, J.D., Leszek, P., Nessler, J., Pawlak, A., et al. (2022) An Expert Opinion of the Heart Failure Association of the Polish Cardiac Society on the 2021 European Society of Cardiology Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure: Heart Failure Guidelines from a National Perspective. Kardiologia Polska, 80, 239-246. https://doi.org/10.33963/kp.a2022.0021 |
| [3] | Gori, M., Marini, M., De Maria, R., Gonzini, L., Gorini, M., Cassaniti, L., et al. (2022) Age-Related Changes in Clinical Characteristics and Outcomes of Chronic Heart Failure Outpatients in a Cardiology Setting. A Report from the Italian Network on Heart Failure. International Journal of Cardiology, 346, 36-44. https://doi.org/10.1016/j.ijcard.2021.11.014 |
| [4] | 陈蒙蒙, 李丽, 陈良余. NT-proBNP联合ALBI评分对急性失代偿性心力衰竭患者出院后1年内死亡的预测价值[J]. 实用心脑肺血管病杂志, 2024, 32(12): 13-16+21. |
| [5] | Xia, Y., Xia, C., Wu, L., Li, Z., Li, H. and Zhang, J. (2023) Systemic Immune Inflammation Index (SII), System Inflammation Response Index (SIRI) and Risk of All-Cause Mortality and Cardiovascular Mortality: A 20-Year Follow-Up Cohort Study of 42,875 US Adults. Journal of Clinical Medicine, 12, Article 1128. https://doi.org/10.3390/jcm12031128 |
| [6] | 钟达香, 肖祖华, 李伟东. CRP、CK-MB、NT-proBNP、cTnI与慢性心力衰竭患者心功能及主要不良心血管事件的关系[J]. 中国医学创新, 2024, 21(30): 114-118. |
| [7] | 程忠良, 凌燕, 梁晓辉. CK-MB、BNP及纤维蛋白原/白蛋白比值对老年慢性心力衰竭病人再入院率的预测价值[J]. 实用老年医学, 2023, 37(2): 168-172. |
| [8] | 张健, 张宇辉, 周蕾. 国家心力衰竭指南2023(精简版) [J]. 中国循环杂志, 2023, 38(12): 1207-1238. |
| [9] | Kelshiker, M.A., Seligman, H., Howard, J.P., et al. (2022) Coronary Flow Reserve and Cardiovascular Outcomes: A Systematic Review and Meta-Analysis. European Heart Journal, 43, 1582-1593. |
| [10] | 张亚男, 斯日古楞, 杨宏昕, 等. 2023欧洲心脏病学会心力衰竭协会《临床共识声明: 慢性心力衰竭恶化的定义、流行病学、管理和预防》解读[J]. 世界临床药物, 2023, 44(10): 1017-1021. |
| [11] | Orso, F., Fabbri, G. and Maggioni, A.P. (2016) Epidemiology of Heart Failure. In: Bauersachs, J., Butler, J. and Sandner, P., Eds., Heart Failure. Handbook of Experimental Pharmacology, Springer International Publishing, 15-33. https://doi.org/10.1007/164_2016_74 |
| [12] | 尹清珂, 刘杨. 慢性心力衰竭患者血清RBP4、Corin、NT-proBNP水平及与心功能的相关性分析[J]. 中国卫生工程学, 2024, 23(6): 783-785. |
| [13] | Oremus, M., Don-Wauchope, A., McKelvie, R., Santaguida, P.L., Hill, S., Balion, C., et al. (2014) BNP and NT-ProBNP as Prognostic Markers in Persons with Chronic Stable Heart Failure. Heart Failure Reviews, 19, 471-505. https://doi.org/10.1007/s10741-014-9439-6 |
| [14] | 吴双, 于海宁, 沈生荣. 有效白蛋白研究进展[J]. 西南医科大学学报, 2024, 47(5): 452-456. |
| [15] | Manolis, A.A., Manolis, T.A., Melita, H., Mikhailidis, D.P. and Manolis, A.S. (2022) Low Serum Albumin: A Neglected Predictor in Patients with Cardiovascular Disease. European Journal of Internal Medicine, 102, 24-39. https://doi.org/10.1016/j.ejim.2022.05.004 |
| [16] | Hoppe, B. (2014) Fibrinogen and Factor XIII at the Intersection of Coagulation, Fibrinolysis and Inflammation. Thrombosis and Haemostasis, 112, 649-658. https://doi.org/10.1160/th14-01-0085 |
| [17] | Meng, Z., Zhao, Y. and He, Y. (2021) Fibrinogen Level Predicts Outcomes in Critically Ill Patients with Acute Exacerbation of Chronic Heart Failure. Disease Markers, 2021, Article ID: 6639393. https://doi.org/10.1155/2021/6639393 |
