心脏彩超检查联合血清BNP、ALB、CysC在慢性心力衰竭患者预后评估中的临床价值分析

摘要 目的：分析心脏彩超检查联合血清B型钠尿肽（BNP）、白蛋白（ALB）、胱抑素C（CysC）在慢性心力衰竭（CHF）患者预后评估中的临床价值。方法：选取2017年6月-2018年5月我院收治的123例CHF患者，心脏彩超检查左心室射血分数（LVEF）、左心房内径（LAD）和左心室内径（LVD），实验室检测血清BNP、ALB、CysC水平。按照3年随访后患者是否死亡分为死亡组35例和存活组88例，收集临床资料，采用多因素Logistic回归分析CHF患者预后的影响因素。采用受试者工作特征（ROC）曲线分析心脏彩超检查联合血清BNP、ALB、CysC对CHF患者预后的评估价值。结果：死亡组患者的LAD、LVD及血清BNP、CysC水平高于存活组患者，而LVEF及血清ALB水平低于存活组患者（P＜0.05）。心脏彩超指标LVEF、LAD、LVD及血清BNP、ALB、CysC是CHF患者预后的影响因素（P＜0.05）。心脏彩超指标LVEF、LAD、LVD联合血清BNP、ALB、CysC检测对CHF患者预后评估的ROC曲线下面积（AUC）（0.95CI）为0.857（0.771～0.938），灵敏度及特异度分别为0.914（32/35）、0.795（70/88），均明显高于上述各指标单独检测。结论：心脏彩超指标LVEF、LAD、LVD和血清BNP、ALB、CysC均为CHF患者预后的影响因素，且联合检测对患者预后的评估价值较高，具有一定的临床应用价值。

Clinical Value Analysis of Cardiac Color Doppler Ultrasound Examination Combined with Serum BNP, ALB, CysC in the Prognosis Assessment of Patients with Chronic Heart Failure

ABSTRACT Objective: To analyze the clinical value of cardiac color Doppler ultrasound examination combined with serum B-type natriuretic peptide (BNP), albumin (ALB) and cystatin C (CysC) in the prognosis assessment of patients with chronic heart failure (CHF). Methods: 123 patients with CHF who were treated in our hospital from June 2017 to May 2018 were selected. Left ventricular ejection fraction (LVEF), left atrial diameter (LAD) and left ventricular diameter (LVD) were examined by cardiac color Doppler ultrasound, and the levels of serum BNP, ALB and Cys C were detected in the laboratory. According to whether the patients died after 3-year follow-up, they were divided into 35 cases in the death group and 88 cases in the survival group. The clinical data were collected, and the influencing factors of the prognosis of patients with CHF were analyzed by multivariate Logistic regression. The receiver operating characteristic (ROC) curve was used to analyze the prognostic value of cardiac color Doppler ultrasound examination combined with serum BNP, ALB and CysC in patients with CHF. Results: The levels of LAD, LVD, serum BNP and CysC in the death group patients were higher than those in the survival group patients, while the levels of LVEF and serum ALB were lower than those in the survival group patients (P<0.05). Cardiac color Doppler index LVEF, LAD, LVD, serum BNP, ALB and CysC were significant prognostic factors in patients with CHF (P<0.05). The area under ROC curve (AUC) (0.95CI) of cardiac color Doppler ultrasound indexes LVEF, LAD, LVD combined with serum BNP, ALB and CysC was 0.857(0.771~0.938), and the sensitivity and specificity were 0.914 (32/35) and 0.795(70/88), respectively, which were significantly higher than the above indexes. Conclusion: Cardiac color Doppler index LVEF, LAD, LVD and serum BNP, ALB, CysC are all factors influencing the prognosis of patients with CHF, and the combined detection has high prognostic value for patients, which is worthy of clinical application.