[1]苏 虹a,王文利b,王 东a,等.冠心病患者血液hs-CRP,ET-1,NO,NT-ProBNP及D-D水平联合检测在评估左心衰竭并发肺动脉高压的临床价值[J].现代检验医学杂志,2021,36(04):147-151.[doi:10.3969/j.issn.1671-7414.2021.04.032]
 SU Honga,WANG Wen-lib,WANG Donga,et al.Clinical Value of Combined Detection of Serum hs-CRP, ET-1, NO, NT-proBNP and D-D Levels in Patients with Coronary Heart Disease in EvaluatingLeft Heart Failure Complicated with Pulmonary Hypertension[J].Journal of Modern Laboratory Medicine,2021,36(04):147-151.[doi:10.3969/j.issn.1671-7414.2021.04.032]
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冠心病患者血液hs-CRP,ET-1,NO,NT-ProBNP及D-D水平联合检测在评估左心衰竭并发肺动脉高压的临床价值()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第36卷
期数:
2021年04期
页码:
147-151
栏目:
检验与临床
出版日期:
2021-07-31

文章信息/Info

Title:
Clinical Value of Combined Detection of Serum hs-CRP, ET-1, NO, NT-proBNP and D-D Levels in Patients with Coronary Heart Disease in EvaluatingLeft Heart Failure Complicated with Pulmonary Hypertension
文章编号:
1671-7414(2021)04-147-05
作者:
苏 虹a王文利b王 东a侯 红a严定一a陈 霞a
(西安市第三医院a. 心血管内科;b. 超声科,西安710018)
Author(s):
SU Honga WANG Wen-lib WANG Donga HOU Honga YAN Ding-yiaCHEN Xiaa
(a.Department of Cardiovascular Medicine; b.Department of Neurology, the Third Hospital of Xi’an ,Xi’an 710018, China)
关键词:
冠心病左心衰竭肺动脉高压联合检测
分类号:
R541.4;R446.11
DOI:
10.3969/j.issn.1671-7414.2021.04.032
文献标志码:
A
摘要:
目的 研究冠心病(coronary heart disease,CHD)患者血清指标联合检测在评估左心衰竭并发肺动脉高压中的临床价值。方法 收集西安市第三医院心血管内科2018 年10 月~2020 年10 月84 例CHD 并发左心室患者临床资料,根据是否伴有肺动脉高压( pulmonary hypertension,PH)将84 例患者分为观察组和对照组。比较两组患者血清相关指标[ 超敏C 反应蛋白(high sentitive C-reactive protein,hs-CRP),内皮素-1(endothelin-1,ET-1),一氧化氮(nitricoxide,NO),氨基末端脑钠肽前体(amino-terminal pro-brain natriuretic peptide,NT-Pro BNP) 和D- 二聚体(D-dimmer,D-D)]。采用Logistic 分析CHD 左心衰竭并发PH 的高危因素,分析血清相关指标判断患者并发PH 的价值。结果 84例患者中26 例发生PH,为观察组,另58 例为对照组。观察组与对照组患者血清hs-CRP,ET-1,NO,NT-Pro BNP及D-D 水平比较,差异有统计学意义(t=4.98,4.27,5.67,9.78 和7.23,均P<0.05)。Logistic 多因素分析显示hs-CRP(β=0.91,95%CI=1.17-5.30,P=0.02),ET-1(β=1.21,95%CI=1.56-7.15,P<0.01),NT-Pro BNP(β=1.01,95%CI=1.32~5.73,P<0.01)及D-D(β=0.62,95%CI=1.34~2.58,P<0.01)是CHD 左心衰竭并发PH 的独立影响因素。基于多因素分析结果建立预测模型Y=0.91X1+1.21X2+1.01X3+0.62X4(X1=hs-CRP,X2=ET-1,X3=NT-Pro BNP,X4=D-D),受试者工作曲线(receiver operating characteristic,ROC)分析结果显示预测模型判断CHD 左心衰竭并发PH 的曲线下面积(area under curve,AUC)为0.80(SE=0.07,95%CI=0.66~0.94,P<0.01),敏感度和特异度分别为0.85和0.73。结论 血清hs-CRP,ET-1,NT-Pro BNP 及D-D 联合检测用于CHD 左心衰竭患者对判断其并发PH 风险具有较高准确性。

参考文献/References:

[1] 朱志远,王海燕,吴波,等.冠心病患者血小板和淋巴细胞比值与冠脉斑块稳定性及预后的相关性[J]. 现代检验医学杂志,2019,34(4):112-115, 119.ZHU Zhiyuan,WANG Haiyan,WU Bo,et al.Correlation between ratio of platelet to lymphocyte withthe stability of coronary artery plaque and prognosisin patients with coronary heart disease [J] .Journal ofModern Laboratory Medicine, 2019,34(4):112-115,119.
[2] 王伟芳,杜薇,丁智超.RVv/LVv 和超声心动图在肺动脉高压诊断中的价值[J]. 中国现代医学杂志,2018,28(32):77-81.WANG Weifang,DU Wei,DING Zhichao. Rightventricular volume to left ventricular volume ratioand echocardiography in diagnosis of pulmonaryhypertension [J]. China Journal of Modern Medicine,2018, 28(32):77-81.
[3] 高建华,何颖辉.冠心病并发幽门螺杆菌感染患者血清HP 抗体谱特征与炎性因子水平相关性分析[J].现代检验医学杂志,2019,34(4):53-57.GAO Jianhua,HE Yinghui. Correlation analysis ofserum antibody spectrum and inflammatory factor levelin patients with coronary heart disease complicatedwith Helicobacter polori infection [J]. Journal ofModern Laboratory Medicine, 2019,34(4):53-57.
[4] 马苑真,董莉.动脉粥样硬化相关血清生物化学及分子生物学检测指标的最新研究进展[J].现代检验医学杂志,2020,35(3):160-164.MA Yuanzhen,DONG Li. Recent advances in thedetection of serum biochemistry and molecular biologyof atherosclerosis [J].Journal of Modern LaboratoryMedicine,2020,35(3):160-164.
[5] REHMAN M B, GARCIA R, CHRISTIAENS L, etal. Power of resting echocardiographic measurementsto classify pulmonary hypertension patients accordingto European society of cardiology exercise testingrisk stratification cut-offs[J]. International Journal ofCardiology, 2018, 257: 291-297.
[6] LEVINE G N, BATES E R, BITTL J A, et al. 2016ACC/AHA guideline focused update on duration ofdual antiplatelet therapy in patients with coronaryartery disease: A report of the American College ofCardiology/American Heart Association Task Forceon Clinical Practice Guidelines.[J]. The Journal ofThoracic and Cardiovascular Surgery, 2016, 152(5) :1243-1275.
[7] 中华医学会心血管病学分会心力衰竭学组,中国医师协会心力衰竭专业委员会,中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南2018[J].中华心血管病杂志,2018, 46(10):760-789.Heart Failure Group of Chinese Society of Cardiologyof Chinese Medical Association, Chinese HeartFailure Association of Chinese Medical DoctorAssociation, Editorial Board of Chinese Journal ofCardiology. Chinese guidelines for the diagnosis andtreatment of heart failure 2018 [J]. Chinese Journal ofCardiovascular Research,2018, 46(10):760-789.
[8] 刘亚东,冯莉莉,王海晶,等.冠心病患者血清Lp-PLA2 与HCY 检测及其与冠状动脉病变程度的相关性分析[J]. 现代检验医学杂志,2018,33(6):83-87.LIU Yadong,FENG Lili,WANG Haijing,et al. Detectionof serum Lp-PLA2 and HCY in patients with coronaryheart disease and its correlation with the degreeof coronary artery disease[J]. Journal of ModernLaboratory Medicine,2018,33(6):83-87.
[9] 欧阳春, 韩振, 叶小强, 等. 冠心病患者ABCA1基因多态性及血清FABP3 水平联合检测与冠状动脉血管病变的相关性研究[J]. 现代检验医学杂志,2020,35(2):1-5, 11.OUYANG Chun,HAN Zhen,YE Xiaoqiang,et al.Correlation of ABCA1 gene polymorphism and serumFABP3 level with coronary artery disease in patientswith coronary heart disease [J]. Journal of ModernLaboratory Medicine, 2020, 35(2):1-5,11.
[10] 曹雅兰,向姝婷,王钰,等.射血分数保留心力衰竭患者无创血流动力学与超声心动图一年随访的对比研究[J]. 中国医师进修杂志,2020,43(8):691-695.CAO Yalan,XIANG Shuting,WANG Yu,et al. Comparativestudy of non-invasive hemodynamics and echocardiographyon heart failure with preserved ejectionfraction patients:one year follow-up [J]. Chinese Journalof Postgraduates of Medicine,2020,43(8):691-695.
[11] 程俊杰, 李静, 梁西强, 等. 非高密度脂蛋白胆固醇与冠心病患者心功能分级的相关性研究[J]. 现代检验医学杂志, 2016,31(3):43-47.CHENG Junjie ,LI Jing ,LIANG Xiqiang ,et al.Correlation between non high density lipoproteincholesterol and cardiac function in patients withcoronary heart disease [J].Journal of ModernLaboratory Medicine, 2016,31(3):43-47.
[12] 罗金,蓝柳萍.血液RDW,Hcy 和NEFA 水平联合检测在冠心病诊断中的应用[J].现代检验医学杂志,2020,35(3):62-65, 80.LUO Jin,LAN Liuping. Application of combineddetection of blood RDW,Hcy and NEFA levels in thediagnosis of coronary heart disease [J]. Journal ofModern Laboratory Medicine,2020,35(3):62-65,80.
[13] 白金娥, 林小艳. 外周血NLR 与PLR 对急性肺梗死患者预后价值探析[J]. 现代检验医学杂志,2017,32(5):137-140, 144.BAI Jine,LIN Xiaoyan. Prognosis affects of neutrophilto lymphocyte ratio and platelet to lymphocyteratio of peripheral blood for patients with acute lunginfarction [J] .Journal of Modern Laboratory Medicine,2017,32(5):137-140,144.
[14] 张学铭,庄琦,杨梦慧,等. 四维超声心动图结合二维斑点追踪技术评价肺动脉高压患者右心功能和预后[J]. 中华心血管病杂志,2018,46(12):965-971.ZHANG Xueming,ZHUANG Qi,YANG Menghui,et al.Value of four-dimensional echocardiography combinedwith speckle tracking technique on the assessment ofright heart function and prognosis in patients with pulmonaryarterial hypertension [J]. Chinese Journal ofCardiology,2018,46(12):965-971.
[15] 戴学庆,涂秀,纪泽森.血液D-D,NT-proBNP 和Trop Ⅰ联合检测在急性胸痛症早期诊断中的价值[J]. 现代检验医学杂志,2018,33(4):115-118.DAI Xueqing,TU Xiu,JI Zesen. Value of combineddetection of blood D-D,NT-proBNP and Trop I inthe early diagnosis of acute chest pain [J]. Journal ofModern Laboratory Medicine,2018,33(4):115-118.
[16] 崔贞, 刘文. 慢性心力衰竭患者呋塞米治疗对血清NT-proBNP 水平的影响[J]. 现代检验医学杂志,2019,34(3):144-147.CUI Zhen,LIU Wen. Effects of furosemide in patientswith chronic heart failure on serum NT-proBNP [J].Journal of Modern Laboratory Medicine, 2019,34(3):144-147.
[17] 汪隆海, 陈启松, 夏芳, 等. 和肽素与大内皮素-1 及N 末端脑钠肽对心力衰竭的预后价值[J]. 现代检验医学杂志,2015,30(1):64-67, 71.WANG Longhai,CHEN Qisong,XIA Fang,et al.Prognostic value of copeptin ,big endothelin-1 andN-terminal pro-Brain natriuretic peptide in patients withchronic heart failure [J] .Journal of Modern LaboratoryMedicine,2015,30(1):64-67,71.
[18] 郭飞波.CypA,BNP,ET-1 浓度在老年慢性心衰患者中的表达及临床意义[J]. 现代检验医学杂志,2016,31(6):88-91.GUO Feibo. Expression characteristics and clinicalsignificance of CypA,BNP and ET-1 in elderly patientswith chronic heart failure [J].Journal of ModernLaboratory Medicine,2016,31(6):88-91.
[19] 王璐,李维娟,杨靖.血清NT-proBNP 和Cys-C 水平联合检测在心力衰竭诊断与分型中的应用[J]. 现代检验医学杂志,2018,33(6):91-94.WANG Lu,LI Weijuan,YANG Jing. Application ofcombined detection of serum NT-proBNP and Cys-Clevels in diagnosis and typing of heart failure [J]. Journalof Modern Laboratory Medicine,2018,33(6):91-94.

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备注/Memo

备注/Memo:
作者简介:苏虹(1984-),女,硕士,主治医师,研究方向:心血管、心衰、冠心病,E-mail:xiansuhong@163.com。
通讯作者:王文利(1987-),女,主治医师,研究生学历,研究方向:超声诊断颈部血管、心脏疾病及产前筛查,E-mail:wwl19877131@126.com。
更新日期/Last Update: 1900-01-01