MR-proADM对慢性心力衰竭的诊断及预后评估价值

发布时间：2018-02-04 07:24

本文关键词： 心力衰竭慢性肾上腺髓质中段肽诊断预后评估　出处：《临床心血管病杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的:研究肾上腺髓质中段肽(MR-proADM)水平对慢性心力衰竭(心衰)的诊断及预后评估价值。方法:随机入选330例慢性心衰患者,同期选择健康体检者90例作为健康对照组。各组入组后24h内及症状缓解后7d均测定N末端脑钠肽前体(NT-proBNP)、MR-proADM、心脏超声(左心室内径及左心室射血分数)等,追踪随访6个月,以心衰再入院及全因死亡为终点,分为事件组与非事件组,分析MR-proADM对慢性心衰的诊断及预后评估价值。结果:与健康对照组相比,慢性心衰患者的MR-proADM水平明显升高(P0.05);MR-proADM水平随着心衰病情加重而升高,经药物治疗后下降,且与NT-proBNP水平有显著正相关。多元逐步回归分析显示,MR-proADM、NT-proBNP、左心室射血分数是慢性心衰患者心衰再入院及病死率的独立预测因素。ROC分析的最佳MR-proADM切点为646.31pmol/L。结论:MR-proADM水平对慢性心衰患者的诊断及预后评估有重要的指导意义。
[Abstract]:Objective: to study the value of MR-proADM in the diagnosis and prognosis of chronic heart failure (CHF). Methods: 330 patients with CHF were randomly selected. At the same time, 90 healthy persons were selected as the healthy control group. MR-proADM was measured within 24 hours after entering the group and 7 days after the remission of symptoms, and the precursor of N-terminal brain natriuretic peptide (NT-proBNPN) was measured. Echocardiography (left ventricular diameter and left ventricular ejection fraction) was followed up for 6 months. The patients were divided into event group and non-event group with readmission and all-cause death as the end point. The value of MR-proADM in the diagnosis and prognosis evaluation of chronic heart failure was analyzed. Results: compared with the healthy control group, the level of MR-proADM in the patients with chronic heart failure was significantly higher than that in the control group (P 0.05). The level of MR-proADM increased with the exacerbation of heart failure, decreased after drug treatment, and had a significant positive correlation with the level of NT-proBNP. Multiple stepwise regression analysis showed. MR-proADMN NT-proBNP. Left ventricular ejection fraction was an independent predictor of readmission and mortality in patients with chronic heart failure. The best MR-proADM point for ROC analysis was 646.31 pmol / L. Conclusion:. The level of MR-proADM plays an important role in the diagnosis and prognosis evaluation of chronic heart failure (CHF).
【作者单位】：上海市嘉定区南翔医院心内科;
【基金】：上海市卫生和计划生育委员会面上项目(No:201440600)
【分类号】：R541.6
【正文快照】： Framingham研究通过40年观察发现,曾入院的心力衰竭(心衰)患者年均病死率高达30%~50%。心衰后男性5年存活率为25%,女性为38%[1]。肾上腺髓质素(Adrenomedullin,ADM)和肾上腺髓质中段肽(Mid-regional pro-adrenomedullin,MR-proADM)是心衰和心血管死亡的独立预测因素,对心衰

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