右心声学造影联合血清cTnⅠ、NT-proBNP对心源性脑梗死的预测价值
Predictive Value of Right Heart Contrast Echocardiography Combined with Serum cTnⅠ and NT-proBNP for Cardiogenic Cerebral Infarction
张惠娟 1陈科兰 1胡伯媛 1徐星 1李颖 1梁向新2
作者信息
- 1. 湖南中医药高等专科学校附属第一医院(湖南省直中医医院)超声科 湖南株洲 412000
- 2. 湖南中医药高等专科学校附属第一医院(湖南省直中医医院)神经内科 湖南株洲 412000
- 折叠
摘要
目的:探讨右心声学造影联合血清心肌肌钙蛋白Ⅰ(cTnⅠ)、N-末端脑利钠肽前体(NT-proBNP)对心源性脑梗死(CE)的预测价值.方法:选择2020年7月至2023年6月湖南中医药高等专科学校附属第一医院收治的急性脑梗死患者128例,根据是否发生CE分为CE组(n=31)和非CE组(n=97).两组均行右心声学造影检查,检测两组血清cTnⅠ、NT-proBNP水平,比较两组右心声学造影参数及血清cTnⅠ、NT-proBNP水平.受试者工作特征(ROC)曲线分析右心声学造影联合血清cTnⅠ、NT-proBNP对CE的预测价值.结果:右心声学造影显示CE组卵圆孔未闭阳性率、右向左分流分级(1级+2级+3级)构成比、卵圆孔长径均显著高于非CE组(P＜0.05).CE组卵圆孔未闭患者活动性房间隔构成比显著高于非CE组卵圆孔未闭患者(P＜0.05).CE组血清cTnⅠ、NT-proBNP水平显著高于非CE组.ROC曲线分析结果显示,卵圆孔未闭、右向左分流分级1级+2级+3级、卵圆孔长径、活动性房间隔、cTnⅠ、NT-proBNP对CE具有一定的预测价值,其中联合检验对CE的预测效能最高,曲线下面积(AUC)为0.867(0.812～0.928).结论:右心声学造影联合血清cTnⅠ、NT-proBNP检查可用于CE的预测.
Abstract
Objective:To investigate the predictive value of right heart contrast echocardiography combined with serum cardiac troponin Ⅰ(cTnⅠ)and N-terminal pro-brain natriuretic peptide(NT-proBNP)for cardiogenic cerebral infarction(CE).Methods:128 patients with acute cerebral infarction who were admitted to the The First Affiliated Hospital of Hunan College of Traditional Chinese Medicine from July 2020 to June 2023 were selected,patients were divided into CE group(n=31)and non CE group(n=97)according to the occurrence of CE.Both groups underwent right heart contrast echocardiography,the levels of serum cTnⅠ and NT-proBNP were detected in two groups,the parameters of right heart contrast echocardiography and the levels of serum cTnⅠ and NT-proBNP were compared between two groups.The predictive value of right heart contrast echocardiography combine with serum cTnⅠ and NT-proBNP for CE were analyzed by receiver operating characteristic(ROC)curve.Results:Right heart contrast echocardiography showed that the positive rate of patent foramen ovale,the proportion of right-to-left shunt(grade 1+grade2+grade3),and the long diameter of foramen ovale in CE group were signifiicantly higher than those in non CE group(P＜0.05).The proportion of active atrial septum in patients with patent foramen ovale in CE group were significantly higher than those in non CE group(P＜0.05).The levels of serum cTnⅠ and NT-proBNP in CE group were significantly higher than those in non CE group.ROC curve analysis showed that,patent foramen ovale,right-to-left shunt grade 1+grade2+grade3,patent foramen ovale length and diameter,active atrial septum,cTnⅠ and NT-proBNP had certain predictive value for CE,the combined test had the highest predictive efficiency for CE,and the area under the curve(AUC)was 0.867(0.812～0.928).Conclusion:Right heart contrast echocardiography combined with serum cTnⅠ and NT-proBNP can predict CE.
关键词
心源性脑梗死/右心声学造影/心肌肌钙蛋白Ⅰ/N-末端脑利钠肽前体/预测价值Key words
Cardiogenic cerebral infarction/Right heart contrast echocardiography/Cardiac troponin Ⅰ/N-terminal pro-brain natriuretic peptide/Predictive value引用本文复制引用
基金项目
湖南省医药卫生科研项目(B2015-77)
出版年
2024
NETL
NSTL
万方数据