本文選題：急性心力衰竭　切入點(diǎn)：D二聚體　出處：《上海大學(xué)學(xué)報(自然科學(xué)版)》2016年03期

【摘要】：探討D二聚體(D-dimer)在急性心力衰竭(acute heart failure,AHF)短期預(yù)后評估中的臨床價值.共選206例患者隨訪3個月,采集心臟病發(fā)作期間靜脈血檢測血常規(guī)、血生化、D-dimer和N末端B型腦鈉肽前體(N-terminal pro-brain natriuretic peptide,NTpro BNP)等指標(biāo).心血管(cardiovascular,CV)事件包括近期因慢性心力衰竭急性發(fā)作需再入院治療或者死亡.發(fā)生心血管事件組的NT-pro BNP及D-dimer的質(zhì)量濃度比未發(fā)生事件組顯著升高(P0.001).受試者工作特征(receiver operating characteristic,ROC)曲線分析顯示:NT-pro BNP預(yù)測AHF患者出院后90 d內(nèi)心血管事件曲線下面積為0.806,D-dimer為0.887.Kaplan-Meier生存曲線分析發(fā)現(xiàn):NT-pro BNP的質(zhì)量濃度2 262.0 pg/m L,Ddimer的質(zhì)量濃度1.1 mg/d L的患者出院后90 d內(nèi)發(fā)生心血管事件的危險性顯著高于其他分組(P0.001).可見D-dimer可作為評估急性心力衰竭短期預(yù)后的生物學(xué)標(biāo)志物,且其在聯(lián)合分析時能提升NT-pro BNP的預(yù)測價值.
[Abstract]:To investigate the clinical value of D-dimer in the short-term prognostic evaluation of acute heart failure in patients with acute heart failure, a total of 206 patients were followed up for 3 months. Blood biochemical markers such as D-dimer and N-terminal B-type brain natriuretic peptide precursor N-terminal pro-brain natriuretic peptideNTpro BNP.Cardiovascular events included readmission to hospital or death due to recent acute episodes of chronic heart failure. NT-pro BNP and D-dimer in the cardiovascular event group. The analysis of receiver operating characteristic roc curve showed that the area under the cardiovascular event curve of AHF patients was 0.806 D dimer 0.806 D dimer within 90 days after discharge from hospital, and the analysis of 0.887.Kaplan-Meier survival curve showed that the ratio of NT-pro BNP to NT-pro BNP was higher than that of non-event group (P 0.001). The risk of cardiovascular events within 90 days after discharge was significantly higher in patients with 2 262.0 pg/m / L Ddimer / 1.1 mg/d / L mass concentration than in other subgroups (P 0.001 / L). Therefore, D-dimer could be used as a biomarker to evaluate the short-term prognosis of acute heart failure. And it can improve the predictive value of NT-pro BNP in joint analysis.
【作者單位】： 南京醫(yī)科大學(xué)第一附屬醫(yī)院心血管內(nèi)科;
【基金】：國家科技支撐計(jì)劃資助項(xiàng)目(2011BAI11B08)
【分類號】：R541.6

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