摘要
目的探讨血清氨基末端脑钠肽前体(NT-proBNP)在非体外循环冠状动脉旁路移植(OPCABG)患者术后变化与预后的相关性。方法选取2019年1月至2020年12月行OPCABG患者96例,入选病例根据术后48 h心脏超声左心室射血分数(LVEF)分为观察组(术后早期发生心功能不全,LVEF≤45%,36例)和对照组(术后早期未发生心功能不全,LVEF>45%,60例),分别测量两组患者术后24 h、48 h及出院前血清NTproBNP水平,同时观察术后主要不良事件,分析NT-proBNP水平与术后早期心功能不全的关系及和预后的相关性。结果观察组术后24 h、48 h血清NT-proBNP水平较对照组升高(P均<0.05),两组患者出院前血清NT-proBNP水平差异无统计学意义(P>0.05);观察组住院期间主要不良事件发生率均较对照组升高(P均<0.05)。NT-proBNP预测术后早期心功能不全的ROC曲线下面积为0.752(95%CI:0.658~0.847,P<0.001),最佳诊断值为6639.00 pg·mL^(-1),敏感度为97.2%,特异度为53.3%。结论术后NT-proBNP水平与非体外循环冠脉旁路移植术后早期心功能不全及术后主要不良事件密切相关,对评估术后早期心功能不全和预后有一定临床意义。
Objective To explore the correlation between expression of NT-proBNP and prognosis in patients after off pump coronary artery bypass grafting(OPCABG).Methods In total,96 patients’retrospective analysis was performed after OPCABG in our hospital from January 2019 to December 2020.The patients were divided into two groups according to the value of LVEF at 48 hours after operation:the observation group(the group with the early postoperative cardiac insufficiency,LVEF≤45%,36 cases)and the control group(the group with the non early cardiac insufficiency,LVEF>45%,60 cases).The serum NT-proBNP levels were measured at 24 hours and 48 hours after operation and before discharge.And the major postoperative adverse events was observed to explore the correlation between expression of NT-proBNP and prognosis in patients after OPCABG.Results The serum NT-proBNP levels measured at 24 hours and 48 hours after operation in the observation group was higher than that in the control group(P all<0.05).There was no significant difference in NT-proBNP before discharge between the two groups(P<0.05).The major postoperative adverse events was higher in the control group(P all<0.05).The serum NT-proBNP predicted that AUCROC was 0.752 for early postoperative cardiac failure(95%CI:0.658-0.847,P<0.001),optimal diagnostic value was 6639.00 pg·mL^(-1),the sensitivity was 97.2%,and the specificity was 53.3%.Conclusion The serum NT-proBNP is closely related to the early postoperative cardiac dysfunction and the major postoperative adverse events in patients with OPCABG,which is of great significance to evaluate and predict postoperative complications of OPCABG.
作者
宋艳艳
赵荣
刘利
SONG Yanyan;ZHAO Rong;LIU Li(Department of Cardiovascular Surgery,the General Hospital of Ningxia Medical Unixersity,Yinchuan 750004,China)
出处
《宁夏医科大学学报》
2023年第7期694-698,共5页
Journal of Ningxia Medical University
基金
2021年自治区重点研发计划社会发展领域立项项目(2021ZDYF0009)。
关键词
氨基末端脑钠肽前体
非体外循环冠状动脉旁路移植术
心功能不全
预后
N-terminal pro brain natriuretic peptide
off pump coronary artery bypass grafting
cardiac insufficiency
prognosis
