| 摘要: |
| 目的探讨甲状腺激素联合B型脑钠肽(BNP)检测对急性心力衰竭（AHF）患者预后的影响。方法纳入AHF患者619例，入院后测定甲状腺激素、BNP。根据患者随访结果分为死亡组和生存组。应用Cox风险模型、ROC曲线和Kaplan-Meier生存曲线分析甲状腺激素和BNP与全因死亡的关系。结果低T3综合征（LT3S）发生率为44.4%。在（19±13）个月随访期间，死亡204例（32.9%）。Cox风险模型分析显示年龄（HR=1.033，95％CI：1.017～1.049，P＜0.01），游离三碘甲状腺原氨酸（FT3）（HR=0.489，95％CI：0.384～0.628，P＜0.01）、BNP（HR=2.136，95%CI：1.114～4.126，P＜0.01）和肌酐（HR=1.002，95％CI：1.001～1.003,P＜0.05）是全因死亡的独立危险因素。根据FT3（≤2.72pmol/L）和BNP（＞2230pg/ml）的切点，Kaplan-Meier生存曲线分析显示低FT3（≤2.72pmol/L）/高BNP（＞2230pg/ml）组患者全因死亡风险最高（HR=7.247，95％CI：3.993～13.152，P＜0.01）。结论FT3是AHF患者全因死亡的独立危险因素，低FT3/高BNP患者远期预后更差。 |
| 关键词: 急性心力衰竭 游离三碘甲状腺原氨酸 B 型脑钠肽 预后 |
| DOI：10.12056/j.issn.1006-2785.2017.39.17.2016-557 |
| 分类号: |
| 基金项目:绍兴市卫生计生科技计划项目（2016CX027） |
|
| Prognosis value of thyroxin with B-type natriuretic peptide for patients with acute heart failure |
|
|
|
Shengzhou People's Hospital，the First Affiliated Hospitalof Zhejiang University Shengzhou Branch
|
| Abstract: |
| Objective To assess the prognostic value of thyroxin combined with B-type natriuretic peptide (BNP) in patients with acute heart failure(AHF). Methods A total of 619 AHF patients were included in this study. Thyroid hormone profile, BNP were measured within 24h after admission. The patients were divided into survival group and non-survival group. Using Cox hazards model, receiver operating characteristic curve and Kaplan-Meier survival analysis, the correlation of thyroid hormone
levels and BNP with all-cause mortalities of patients was assessed. Results The incidence of low triiodothyronine syndrome (LT3S) in patients with AHF was 44.4% . At the median follow-up time of 19 ±13 months, 204 patients (32.9% ) were died. Multivariate Cox regression analysis showed that age (HR=1.033, 95％ CI:1.017-1.049, P ＜0.01), FT3 (HR=0.489, 95％ CI: 0.384-0.628, P＜0.01), BNP (HR=2.136, 95% CI:1.114-4.126, P＜0.01) and serum creatinine (HR=1.002, 95%CI: 1.001-1.003,
P＜0.05) were independent predictors for all-cause mortality. Based on the cut-off value of FT3(≤2.72 pmol/L) and BNP(＞2 230 pg/ml), Kaplan-Meier analysis provided the significant prognostic information with the highest risk of all-cause death (HR=7.247, 95％CI: 3.993-13.152, P＜0.01) in the low FT3 (≤2.72 pmol/L)/high BNP (＞2 230pg/ml) group. Conclusion FT3 levels appear to be independent predictor for all-cause mortalities among AHF patients, and low FT3 and high BNP levels predicts a worse
long-term outcome. |
| Key words: Acute heart failure Free triiodothyronin B-type natriuretic peptides Prognosis |
