BNP联合cTnT对UAP合并CHF的诊断及术后不良心血管事件的预测

摘要/Abstract

摘要： 目的探讨脑钠肽（BNP）联合肌钙蛋白（cTnT）对冠心病不稳定型心绞痛（UAP）合并慢性心力衰竭（CHF）的诊断效能及介入术后不良心血管事件的预测价值。方法选取2020年5月—2023年5月天水市第一人民医院收治的患者,85例冠心病不稳定型心绞痛合并慢性心力衰竭患者作为慢性心力衰竭组,85例单纯冠心病不稳定型心绞痛未并发慢性心力衰竭患者作为非慢性心力衰竭组,体检的85名健康志愿者作为对照组。比较三组患者BNP、cTnT表达水平,并建立受试者特征（ROC）工作曲线分析BNP联合cTnT对冠心病不稳定型心绞痛合并慢性心力衰竭的诊断效能。随后将85例冠心病不稳定型心绞痛合并慢性心力衰竭PCI术后近期是否发生不良心血管事件（MACE）分为非MACE组（n=64）和MACE组（n=21）,比较两组患者临床特征,并分析BNP、cTnT对冠心病不稳定型心绞痛合并慢性心力衰竭介入术后不良心血管事件的预测价值。结果三组受检者BNP、cTnT水平比较,差异有统计学意义（P<0.05）。慢性心力衰竭组BNP、cTnT水平明显高于非慢性心力衰竭组和对照组,差异有统计学意义（P<0.05）。BNP联合cTnT对冠心病不稳定型心绞痛合并慢性心力衰竭的诊断效能优于单一检测（P<0.05）。非MACE组与MACE组患者性别、BMI、合并基础疾病情况、饮酒史、吸烟史比较,差异无统计学意义（P>0.05）;两组患者年龄、心功能分级、左室射血分数、TIMI评分、BNP以及cTnT表达水平比较,差异有统计学意义（P<0.05）。logistic回归分析结果表明：BNP、cTnT为冠心病不稳定型心绞痛合并慢性心力衰竭介入术后不良心血管事件的独立危险因素（P<0.05）。结论 BNP联合cTnT可提升冠心病不稳定型心绞痛合并慢性心力衰竭的诊断效能,且BNP、cTnT为冠心病不稳定型心绞痛合并慢性心力衰竭介入手术后主要心血管事件的独立危险因素。提示临床上对于BNP、cTnT升高的冠心病不稳定型心绞痛合并慢性心力衰竭介入手术患者注意及时采取相关措施预防心血管不良事件的发生。

关键词: 脑钠肽, 肌钙蛋白, 冠心病, 不稳定型心绞痛, 慢性心力衰竭, 不良心血管事件

Abstract: Objective To explore the diagnostic efficacy of brain natriuretic peptide (BNP) combined with troponin (cTnT) in unstable angina pectoris with chronic heart failure in coronary heart disease and the predictive value of adverse cardiovascular events after interventional surgery. Methods Select Tianshui first people's hospital from May 2020 to May 2023 admitted patients: 85 cases of coronary heart disease unstable angina with chronic heart failure as chronic heart failure group, 85 cases of pure coronary heart disease unstable angina without complicated chronic heart failure group as a chronic heart failure, 85 cases of healthy volunteers as a control group. Compare the expression levels of BNP and cTnT in three groups of patients, and establish a receiver characteristic (ROC) working curve to analyze the diagnostic efficacy of BNP combined with cTnT in unstable angina pectoris with chronic heart failure. Subsequently, 85 patients with unstable angina pectoris complicated by chronic heart failure who underwent PCI were divided into two groups: non MACE group (n=64) and MACE group (n=21). The clinical characteristics of the two groups of patients were compared, and the predictive value of BNP and cTnT for adverse cardiovascular events after percutaneous coronary intervention in unstable angina pectoris complicated by chronic heart failure was analyzed. Results There was a significant difference in the levels of BNP and cTnT among the three groups of subjects. The levels of BNP and cTnT in the chronic heart failure group were significantly higher than those in the non chronic heart failure group and the control group (P<0.05); The combination of BNP and cTnT is superior to a single test in the diagnosis of unstable angina pectoris with chronic heart failure in coronary heart disease (P<0.05); There was no significant difference in gender, BMI, comorbidities, drinking history, and smoking history between the non MACE group and the MACE group (P>0.05). There was a significant difference in age, cardiac function grading, left ventricular ejection fraction, TIMI score, BNP, and cTnT expression levels between the two groups (P<0.05); The results of logistic regression analysis showed that BNP and cTnT were independent risk factors for adverse cardiovascular events after intervention in unstable angina pectoris with chronic heart failure (P<0.05). Conclusion BNP combined with cTnT can improve the diagnostic efficacy of unstable angina pectoris with chronic heart failure, and BNP and cTnT are independent risk factors for the main cardiac blood events after interventional surgery for unstable angina pectoris with chronic heart failure. It is suggested that in clinical practice, patients with unstable angina pectoris and chronic heart failure complicated by elevated BNP and cTnT should take timely measures to prevent cardiovascular adverse events.

Key words: brain natriuretic peptide, troponin, coronary heart disease, unstable angina pectoris, chronic heart failure, adverse cardiovascular events

中图分类号:

R541

王苑. BNP联合cTnT对UAP合并CHF的诊断及术后不良心血管事件的预测[J]. 中华养生保健, 2024, 42(9): 48-52.

WANG Yuan. Diagnostic Efficacy of Brain Natriuretic Peptide combined with Cardiac Troponin in Unstable Angina Pectoris with Chronic Heart Failure in Coronary Heart Disease and Predictive Value of Adverse Cardiovascular Events after Interventional Surgery[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(9): 48-52.

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