D二聚体评估急性心力衰竭短期预后的临床意义

发布时间：2018-03-26 02:05

本文选题：急性心力衰竭　切入点：D二聚体　出处：《上海大学学报(自然科学版)》2016年03期

【摘要】：探讨D二聚体(D-dimer)在急性心力衰竭(acute heart failure,AHF)短期预后评估中的临床价值.共选206例患者随访3个月,采集心脏病发作期间静脉血检测血常规、血生化、D-dimer和N末端B型脑钠肽前体(N-terminal pro-brain natriuretic peptide,NTpro BNP)等指标.心血管(cardiovascular,CV)事件包括近期因慢性心力衰竭急性发作需再入院治疗或者死亡.发生心血管事件组的NT-pro BNP及D-dimer的质量浓度比未发生事件组显著升高(P0.001).受试者工作特征(receiver operating characteristic,ROC)曲线分析显示:NT-pro BNP预测AHF患者出院后90 d内心血管事件曲线下面积为0.806,D-dimer为0.887.Kaplan-Meier生存曲线分析发现:NT-pro BNP的质量浓度2 262.0 pg/m L,Ddimer的质量浓度1.1 mg/d L的患者出院后90 d内发生心血管事件的危险性显著高于其他分组(P0.001).可见D-dimer可作为评估急性心力衰竭短期预后的生物学标志物,且其在联合分析时能提升NT-pro BNP的预测价值.
[Abstract]:To investigate the clinical value of D-dimer in the short-term prognostic evaluation of acute heart failure in patients with acute heart failure, a total of 206 patients were followed up for 3 months. Blood biochemical markers such as D-dimer and N-terminal B-type brain natriuretic peptide precursor N-terminal pro-brain natriuretic peptideNTpro BNP.Cardiovascular events included readmission to hospital or death due to recent acute episodes of chronic heart failure. NT-pro BNP and D-dimer in the cardiovascular event group. The analysis of receiver operating characteristic roc curve showed that the area under the cardiovascular event curve of AHF patients was 0.806 D dimer 0.806 D dimer within 90 days after discharge from hospital, and the analysis of 0.887.Kaplan-Meier survival curve showed that the ratio of NT-pro BNP to NT-pro BNP was higher than that of non-event group (P 0.001). The risk of cardiovascular events within 90 days after discharge was significantly higher in patients with 2 262.0 pg/m / L Ddimer / 1.1 mg/d / L mass concentration than in other subgroups (P 0.001 / L). Therefore, D-dimer could be used as a biomarker to evaluate the short-term prognosis of acute heart failure. And it can improve the predictive value of NT-pro BNP in joint analysis.
【作者单位】：南京医科大学第一附属医院心血管内科;
【基金】：国家科技支撑计划资助项目(2011BAI11B08)
【分类号】：R541.6

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