超声结合NT-proBNP、TUG1在老年高血压伴射血分数保留心衰患者中的评估价值研究

摘要 目的：探究心脏超声指标结合N末端B型脑钠肽前体(NT-proBNP)、长链非编码RNA(1ncRNA)牛磺酸上调基因1(TUG1)在老年高血压伴射血分数保留心衰(HFPEF)患者的临床价值。方法：以2021年3月至2022年3月于邯郸市第一医院接受诊疗的82例老年高血压伴HFPEF患者为研究组，依据纽约心脏病学会(NYHA)心功能分级将患者分为A亚组(Ⅰ~Ⅱ级)48例及B亚组(Ⅲ~Ⅳ级)34例，另选取同期接受检查的74例老年高血压未合并HFPEF的患者作为对照组。记录所有研究对象的心脏超声参数，并检测其血清NT-proBNP、TUG1水平。采用受试者特征工作曲线(ROC)评价超声参数结合NT-proBNP、TUG1对老年高血压伴HFPEF的诊断价值，并评价其对老年高血压伴HFPEF严重程度的评估价值。结果：研究组的左房内径(LAD)、血清NT-proBNP、TUG1水平高于对照组，舒张早期二尖瓣血流速度/舒张晚期二尖瓣血流速度(E/A)低于对照组(P＜0.05)；B亚组的LAD、血清NT-proBNP、TUG1水平高于A亚组，E/A低于A亚组(P＜0.05)。ROC曲线分析结果显示，LAD、E/A联合血清NT-proBNP、TUG1评价老年高血压伴HFPEF的曲线下面积(AUC)、灵敏度、特异度分别为0.876，0.854、0.838；同时LAD、E/A联合血清NT-proBNP、TUG1评估老年高血压伴HFPEF严重程度的AUC、灵敏度、特异性分别为0.851、0.853、0.833，联合评估效能均优于各指标单独评估。结论：心脏超声参数、NT-proBNP、TUG1在老年高血压伴HFPEF患者的诊断及病情评估中具有一定的临床价值，其中LAD、E/A参数与血清NT-proBNP、TUG1联合评估的价值更高。

Evaluation Value of Ultrasound Combined with NT-proBNP and TUG1 in Elderly Patients with Hypertension and Heart Failure with Preserved Ejection Fraction

ABSTRACT Objective: To investigate the clinical value of echocardiography combined with N-terminal pro-brain natriuretic peptide (NT-proBNP) and long non-coding RNA (1ncRNA) taurine-upregulated gene 1 (TUG1) in elderly patients with hypertension and heart failure with preserved ejection fraction (HFPEF). Methods: 82 elderly patients with hypertension and HFPEF who were diagnosed and treated in Handan First Hospital from March 2021 to March 2022 were selected as the study group. According to new York Heart Association (NYHA) cardiac function classification, the patients were divided into subgroup A (Ⅰ~Ⅱ) 48 cases and subgroup B (Ⅲ~Ⅳ) 34 cases. In addition, 74 elderly patients with hypertension without HFPEF who were examined during the same period were selected as the control group. The cardiac ultrasound parameters of all subjects were recorded, and their serum NT-proBNP and TUG1 levels were detected. Receiver operating characteristic curve (ROC) was used to evaluate the diagnostic value of ultrasound parameters combined with NT-proBNP and TUG1 in elderly patients with hypertension and HFPEF, and to evaluate the value of ultrasound parameters in evaluating the severity of elderly patients with hypertension and HFPEF. Results: The left atrial diameter (LAD), serum NT-proBNP and TUG-1 levels in study group were higher than those in control group, and the ratio of early diastolic mitral flow velocity to late diastolic mitral flow velocity (E/A) was lower than that in control group(P＜0.05). The LAD, NT-proBNP and TUG1 levels in subgroup B were higher than those in subgroup A, and E/A was lower than that in subgroup A(P＜0.05). The results of ROC curve analysis showed that the area under the curve(AUC), sensitivity and specificity of LAD, E/A combined with serum NT-proBNP and TUG1 in the evaluation of elderly hypertension with HFPEF were 0.876, 0.854 and 0.838, respectively. At the same time, the AUC, sensitivity and specificity of LAD, E/A combined with serum NT-proBNP and TUG1 in evaluating the severity of elderly hypertension with HFPEF were 0.851, 0.853 and 0.833, respectively, the combined evaluation efficiency was better than that of each index alone. Conclusion: Cardiac ultrasound parameters, NT-proBNP and TUG-1 have certain clinical value in the diagnosis and evaluation of elderly hypertensive patients with HFPEF, and LAD, E/A parameters combined with serum NT-proBNP and TUG-1 have higher value.