摘要
目的:探讨血清尿酸(SUA)及脑钠肽(BNP)水平对射血分数保留型心力衰竭(HFpEF)并发心房颤动(AF)的诊断价值.方法:选择山东中医药大学第二附属医院2021年12月～2022年12月收治的109例HFpEF患者.根据是否发生AF,患者被分为窦性心律(SR)组(62例)和AF组(47例).收集、检测并比较两组包括SUA、BNP水平在内的一般资料.采用Logistic回归分析HFpEF患者发生AF的影响因素,使用ROC曲线分析SUA、BNP对HFpEF患者发生AF的诊断价值.结果:与SR组比较,AF组高血压(71.0％比93.6％)、NYHAⅢ 级比例(21.0％比 40.4％)、SUA[(399.57±43.15)μmol/L 比(462.40±78.38)μmol/L]、BNP[(2840.70 ±802.14)ng/L 比(4013.83±1102.03)ng/L]水平、左房内径[(38.94±4.31)mm比(42.26±5.48)mm]均显著升高,LVEF[(65.79±9.66)％比(58.69±5.39)％]显著降低,P＜0.05 或＜0.01.多因素 Logistic 回归分析显示,SUA、BNP、LAD均为HFpEF患者发生AF的独立危险因素(OR=1.001～1.153,P＜0.05或＜0.01),而LVEF为其独立保护因素(OR=0.874,P=0.006).ROC曲线分析显示,SUA、BNP及二者联合诊断HFpEF患者发生AF的AUC分别为0.747、0.815、0.894,联合检测的AUC显著高于SUA、BNP单一检测(Z=3.222、2.221,P=0.001、0.026).结论:血清尿酸、脑钠肽在HFpEF患者中显著升高,且为此类患者发生AF的独立危险因素,二者联合检测对HFpEF发生AF的诊断效能较高,可为临床诊疗提供指导.
Abstract
Objective:To investigate the diagnostic value of serum uric acid(SUA)and brain natriuretic peptide(BNP)levels for atrial fibrillation(AF)in patients with heart failure with preserved ejection fraction(HFpEF).Methods:A total of 109 HFpEF patients,who were treated in Second Affiliated Hospital of Shandong University of Traditional Chinese Medi-cine from Dec 2021 to Dec 2022,were selected.According to occurrence of AF or not,patients were divided into sinus rhythm(SR)group(n=62)and AF group(n=47).General data,including SUA and BNP levels,were collected,meas-ured and compared between two groups.Logistic regression was used to analyze influencing factors of AF in HFpEF pa-tients,and ROC curve was used to analyze diagnostic value of SUA and BN P for AF in HFpEF patients.Results:Compared with SR group,there were significant rise in percentages of hypertension(71.0％vs.93.6％)and NYHA class Ⅲ(21.0％vs.40.4％),levels of SUA[(399.57±43.15)μmol/L vs.(462.40±78.38)μmol/L]and BNP[(2840.70±802.14)ng/L vs.(4013.83±1102.03)ng/L],and left atrial diameter(LAD)[(38.94±4.31)mm vs.(42.26±5.48)mm],and significant reduction in LVEF[(65.79±9.66)％vs.(58.69±5.39)％]in AF group,P＜0.05 or＜0.01.Multifac-tor Logistic regression analysis indicated that SUA,BNP and LAD were independent risk factors for AF in HFpEF patients(OR=1.001～1.153,P＜0.05 or＜0.01),while LVEF was its independent protective factor(OR=0.874,P=0.006).ROC curve analysis indicated that AUC of SUA,BNP and their combination diagnosing AF in HFpEF patients was 0.747,0.815 and 0.894 respectively,and AUC of combined detection was significantly higher than those of SUA and BNP single detection(Z=3.222,2.221,P=0.001,0.026).Conclusion:Serum uric acid and brain natriuretic peptide levels signifi-cantly rise in HFpEF patients,and they are independent risk factors for the development of AF in these patients.Combined detection has high diagnostic efficacy for AF in HFpEF,and can provide guidance for clinical diagnosis and treatment.
维普
万方数据