摘要
目的探讨充血性心力衰竭(CHF)患者血气分析、血清心功能指标及其与预后的关系。方法回顾性分析2017年12月~2019年12月我院收治的105例CHF患者临床资料,患者治疗前均进行血气分析监测,并检测血清N末端-脑钠肽前体(NT-proBNP)水平。根据患者治疗28天后的生存情况进行分组,比较不同生存状态患者治疗前血气分析指标及血清N-proBNP水平差异。分析检测指标与患者预后的相关性,并绘制受试者工作特征曲线(ROC)评价检测指标评估患者预后的效能。结果死亡组与存活组患者动脉血氧分压(PaO_(2))、氧偏移度水平比较差异无统计学意义(P>0.05);存活组患者动脉二氧化碳分压(PaCO_(2))、经皮氧分压(TcPO_(2))水平显著高于死亡组(P<0.05),经皮二氧化碳分压(TcPCO_(2))、二氧化碳偏移度及血清NT-proBNP水平均显著低于死亡组(P<0.05)。CHF患者TcPO_(2)、TcPCO_(2)水平对应与PaO_(2)、PaCO_(2)水平呈正相关(r=0.667,0.988,P<0.05),TcPO_(2)与血清NT-proBNP水平呈负相关(r=-0.536,P<0.05),TcPCO_(2)水平与血清NT-proBNP呈正相关(r=0.524,P<0.05)。ROC曲线分析显示,二氧化碳偏移度、NT-proBNP水平评估CHF患者预后的曲线下面积为0.813、0.846,阈值为0.467、1946 ng/L,诊断敏感度为77.14%和84.76%,特异度为75.24%和89.52%,联合诊断敏感度和特异度分别为93.33%和90.48%。结论CHF患者入院后应动态监测血气分析指标与血清NT-proBNP水平,二氧化碳偏移度与血清NT-proBNP可用于评估CHF患者预后。
Objective This research was to explore the blood gas analysis and serum cardiac function indexes and their relationship with prognosis in patients with congestive heart failure(CHF).Methods The clinical data of 105 patients with CHF admitted to our hospital from December 2017 to December 2019 were retrospectively analyzed.All patients underwent blood gas analysis monitoring before treatment.The serum N-terminal pro-brain natriuretic peptide(NT-proBNP)level was detected.The patients were grouped according to the survival status of patients after 28 d of treatment.The differences in blood gas analysis indexes and serum N-proBNP were compared among patients with different survival status before treatment.The correlation between the detection indexes and prognosis was analyzed,and receiver operating characteristic(ROC)curves were drawn to evaluate the efficacy of the detection indexes in evaluating the prognosis of patients.Results There were no significant differences in the arterial partial pressure of oxygen(PaO_(2))and oxygen deviation between death group and survival group(P>0.05).Arterial partial pressure of carbon dioxide(PaCO_(2))and transcutaneous oxygen partial pressure(TcPO_(2))in survival group were significantly higher than those in death group(P<0.05),while transcutaneous carbon dioxide partial pressure(TcPCO_(2)),carbon dioxide deviation and serum NT-proBNP were significantly lower than those in death group(P<0.05).TcPO_(2) and TcPCO_(2) in patients with CHF were positively correlated with PaO_(2) and PaCO_(2)(r=0.667,0.988,P<0.05),and TcPO_(2) was negatively correlated with serum NT-proBNP(r=-0.536,P<0.05),and TcPCO_(2) was positively correlated with serum NT-proBNP(r=0.524,P<0.05).ROC curve analysis showed that the area under the curve,threshold value,diagnostic sensitivity and specificity of carbon dioxide deviation in assessing the prognosis of patients with CHF were 0.813,0.467,77.140%and 75.24%,and the above values of NT-proBNP in assessing the prognosis were 0.846,1946ng/l,84.76%and 89.52%respectively,and the sensitivity and specificity of combined diagnosis were 93.33%and 90.48%respectively.ConclusionIt is necessary to dynamically monitor the blood gas analysis indexes and serum NT-proBNP of patients with CHF after admission.Carbon dioxide deviation and serum NT-proBNP can be used to evaluate the prognosis of patients with CHF.
作者
舒银珍
全晖
曾志荣
黄琦
蔡明燕
SHU Yinzhen;QUAN Hui;ZENG Zhirong;HUANG Qi;CAI Mingyan(Department of Laboratory Medicine, The Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, Chengdu 610051, China;Department of Cardiovascular Medicine, The Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, Chengdu 610051, China)
出处
《西部医学》
2021年第7期1052-1055,共4页
Medical Journal of West China
基金
四川省医学会科研项目(2019TG20)。
关键词
充血性心力衰竭
血气分析
血清心功能指标
预后
Congestive heart failure
Blood gas analysis
Serum cardiac function indexes
Prognosis
