血清炎症指标在预测老年急性左心衰竭并发心脏不良事件中的应用价值

摘要

目的：探讨血清炎症指标在预测老年急性左心衰竭并发心脏不良事件中的价值。方法分析在本院接受治疗的89例急性左心衰竭患者的临床资料，依据患者住院期间是否发生心脏不良事件分为事件组23例和对照组66例。结果事件组年龄≥70岁、血糖≥7 mmol /L 的患者比例显著高于对照组；事件组血清 TNF-α、IL-6及 NT-proBNP 水平均显著高于对照组（P＜0．01）。Logistic 回归分析显示，TNF-α≥18．0 ng/L、IL-6≥16．0 ng/L 及 NT-proBNP≥4．5μg/L 是老年急性心力衰竭并发心脏不良事件的独立风险因素（P ＜0．01）。Pearson相关性分析显示，血清NT-proBNP与TNF-α及IL-6呈现显著正相关（P ＜0．01）。ROC曲线分析显示，当NT-proBNP取值为4．61μg /L时，预测老年急性左心衰竭并发心脏不良事件的敏感性为91．23％，特异性为90．02％，优于 TNF-α及 IL-6。结论NT-proBNP≥4．61μg/L 在预测老年急性左心衰竭并发心脏不良事件中的价值较高，其与 TNF-α及 IL-6呈现显著正相关。%Objective To explore the value of serum inflammatory markers in the prediction of cardiac adverse events in elderly patients with acute left heart failure.Methods Clinical materials of 89 patients with acute left heart failure were analyzed,and they were divided into the event group (n=23)and control group (n =66)according to result of adverse cardiovascular events.Results Rati-os of patients with age over 70 years old and glucose level≥7 mmol /L in the event group were signifi-cantly higher than those in the control group,and TNF-α,IL-6 and NT-proBNP levels of event group serum were significantly higher than those of control group (P <0.01 ).Logistic regression analysis showed that TNF-α≥18.0 ng/L,IL-6≥16.0 ng/L and NT-proBNP≥4.5 μg/L were independent risk factors for senile acute heart failure patients complicated with cardiac adverse events (P <0.01). Pearson correlation analysis showed that serum NT-proBNP was positively correlated with TNF-αand IL-6 (P <0.01).ROC curve analysis showed that when the NT-proBNP value was 4.61 μg/L,the sensitivity of elderly acute left heart failure patients complicated with cardiac adverse events was 91.23%,the specificity was 90.02%,which were superior to those of TNF-αand IL-6.Conclusion NT-proBNP≥4.61 μg/L shows a higher predictive value in elderly acute left heart failure patients complicated with cardiac adverse events,and it is positively correlated with TNF-αand IL-6.