血浆sST2联合NT-proBNP对急诊心衰患者生存状况的预测价值

目的探讨血浆sST2联合NT-proBNP对急诊心衰患者生存状况的预测价值.方法选择急诊心衰患者130例,分为心功能Ⅱ级组、心功能Ⅲ~Ⅳ级组,对照组选择健康的体检者60例.对3组NT-proBNP及血浆sST2水平进行观察对比,对心功能不同分级患者NT-proBNP及血浆sST2水平进行比较,比较NT-proBNP,sST2,NTproBNP联合血浆sST2对心衰患者死亡状况的预测价值.结果随心功能分级递增,NT-proBNP水平逐渐升高,sST2曲线下面积(0.776)及NT-proBNP对死亡判定的ROC曲线与NT-proBNP曲线下面积(0.775)相比较没有明显差异,但二者联合曲线下面积为0.813,与NT-proBNP及sST2曲线下面积相比较差异显著.sST2联合NTproBNP进行心衰患者死亡状况预测时的敏感度为99.0%,特异度为93.2%.结论作为急诊心衰患者诊断、预后和风险评估的主要标志物,sST2联合NT-proBNP对患者生存状况进行评估可以很好地预测患者的生存状况,提高准确度和敏感度,值得在临床上推广应用.

Predictive Value of Plasma sST2 Combined with NT-proBNP on the Subsistence Condition of Patients with Acute Heart Failure in Emergency

Objective To investigate the predictive value of plasma sST2 combined with NT-proBNP on the subsistence conditions of patients with heart failure in emergency. Method 130 patients with heart failure were selected,and 60 healthy subjects were chosen as the control. According to the heart function grade,the patients were divided into grade II group,and grade III~IV. The levels of NT-proBNP and plasma sST2 of all the groups were observed and compared. And the values of NT-proBNP,sST2,and NT-proBNP combined with plasma sST2 in predicting the mortal situation of the patients with heart failure were also compared. Results The results suggested that,with the increase of the heart function grade the NT-proBNP level increased gradually,the area under curve (AUC) of ROC which was used to determine the mortal situation,there was significant difference between sST2 (0. 776) and NT-proBNP (0. 775). But the AUC of the combined curve was obviously higher than the AUC of the single curve. The sensitivity of sST2 combined with NT-proBNP for the prediction of mortal situation in patients with heart failure was 99. 0%,and the specificity was 93. 2%. Conclusion The diagnosis, prognosis and risk assessment of acute heart failure patients are taken as the main markers,sST2 combined with NT-proBNP can well predict the survival status of the patients, and improve the accuracy and sensitivity. It is worthy to be popularized and applied in clinic.