血浆容量预测慢性收缩性心力衰竭患者的预后价值

Prognostic value of plasma volume in patients with chronic systolic heart failure

  • 摘要:
      目的  分析血浆容量(PV)预测慢性收缩性心力衰竭(SHF)患者短期预后的价值。
      方法  选择慢性SHF患者左室射血分数(LVEF) < 40%160例为研究对象,根据入院PV(100-红细胞压积(%)/血红蛋白(g/L)水平分为Q1组(< 3.41)52例、Q2组(≥3.41~ < 4.38)55例和Q3组(≥4.38)53例,随访记录全因死亡事件。
      结果  Q1组、Q2组、Q3组患者年龄、N末端B型脑利钠肽前体(NT-proBNP)水平、肌酐水平、红细胞压积呈升高趋势,收缩压和舒张压、血红蛋白水平呈降低趋势,组间比较差异均有统计学意义(P < 0.05)。随访截至2021年4月,共45例全因死亡(28.1%), 其中Q1组7例(13.5%)、Q2组13例(23.6%)和Q3组25例(47.2%), 全因死亡率呈逐渐增加趋势,组间比较差异均有统计学意义(P < 0.05)。PV和ln(NT-proBNP)升高是全因死亡的独立危险因素(P < 0.05)。受试者工作特征(ROC)曲线分析显示, PV、ln(NT-proBNP)以及联合诊断预测全因死亡的曲线下面积(AUC)分别为0.753、0.692和0.841(P < 0.05)。
      结论  慢性SHF患者PV升高对预测短期全因死亡有重要的应用价值,有望成为指导临床早期评估患者预后的重要指标。

     

    Abstract:
      Objective  To analyze the value of plasma volume (PV) in predicting the short-term prognosis of patients with chronic systolic heart failure (SHF).
      Methods  A total of 160 patients with chronic SHFleft ventricular ejection fraction (LVEF) < 40% were selected. According to the admission PV(100-hematocrit(%)/hemoglobin(g/L)level, 52 patients were in Q1 group (< 3.41), 55 patients were in Q2 group (≥3.41~ < 4.38) and 53 patients were in Q3 group (≥4.38). All cause deaths were recorded during follow-up.
      Results  Age, N-terminal B-type brain natriuretic peptide precursor (NT-proBNP) level, creatinine level and hematocrit of patients in the group Q1, group Q2 and group Q3 showed an increasing trend, while systolic and diastolic blood pressure and hemoglobin level showed a decreasing trend, and the differences between groups were statistically significant (P < 0.05). Up to April 2021, a total of 45 cases (28.1%) had all-cause death, including 7 cases (13.5%) in group Q1, 13 cases (23.6%) in group Q2 and 25 cases (47.2%) in group Q3. The all-cause mortality showed a gradual increase trend, and the differences between groups were statistically significant (P < 0.05). Increased PV and In (NT-proBNP) were independent risk factors for all-cause death (P < 0.05). The increase of PV and ln (NT-proBNP) were the independent risk factor to all-cause death (P < 0.05). Receiver operator characteristic (ROC) curve showed that the area under the curve(AUC) of PV, ln (NT-proBNP) and combined diagnosis for all-cause death were 0.753, 0.692 and 0.841 (P < 0.05), respectively.
      Conclusion  The increase of PV in patients with chronic SHF has important application value in predicting short-term all-cause death, and it is expected to be an important index to guide the early clinical evaluation of patients' prognosis.

     

/

返回文章
返回