血清proBNP、RDW-CV对射血分数保留型心力衰竭患者发生主要心血管不良事件的预测价值

Predictive value of serum proBNP and RDW-CV for MACEs in patients with heart failure with preserved ejection fraction

摘要:

目的 探讨血清N端B型脑钠肽前体（proBNP）、红细胞分布宽度变异系数（RDW-CV）对射血分数保留型（HFpEF）心力衰竭（以下简称心衰）患者发生主要心血管不良事件（MACEs）的预测价值。方法 选取2023年1月—2023年12月成都中医药大学附属龙泉中医医院收治的106例HFpEF心衰患者作为研究对象，记录患者出院后12个月内MACEs的发生情况，根据MACEs发生情况分为MACEs组、非MACEs组。比较两组的proBNP、RDW-CV表达差异，分析HFpEF心衰患者发生MACEs的影响因素分析，评估RDW-CV、proBNP对HFpEF心衰患者发生MACEs的预测价值。结果 106例HFpEF心衰患者中32例患者发生MACEs，占比30.19%。MACEs组RDW-CV、proBNP水平均高于非MACEs组（P <0.05），红细胞比容低于非MACEs组（P <0.05）。多因素逐步Logistic回归分析结果显示：红细胞比容低［O^R=0.242（95% CI：0.097，0.606）］、RDW-CV水平高［O^R=3.955（95% CI：1.595，10.006）］、proBNP水平高［O^R=4.354（95% CI：1.738，10.905）］均为HFpEF心衰患者发生MACEs的危险因素（P <0.05）。受试者工作特征曲线结果分析得出，RDW-CV、proBNP及其联合预测HFpEF心衰患者发生MACEs的敏感性为77.1%（95% CI：0.683，0.845）、83.5%（95% CI：0.729，0.921）、91.4%（95% CI：0.813，0.996），特异性为79.5%（95% CI：0.701，0.889）、65.3%（95% CI：0.574，0.712）、61.4%（95% CI：0.561，0.709）。结论 RDW-CV、proBNP预测HFpEF心衰患者发生MACEs的效能良好。

Abstract:

Objective To explore the predictive value of serum N-terminal pro-B-type natriuretic peptide (proBNP) and red blood cell distribution width-coefficient of variation (RDW-CV) for the occurrence of major adverse cardiovascular events (MACEs) in patients with heart failure with preserved ejection fraction (HFpEF).Methods A total of 106 HFpEF patients admitted to the Longquan Traditional Chinese Medicine Hospital Affiliated to Chengdu University of Traditional Chinese Medicine from January to December 2023 were selected as the study subjects. The occurrence of MACEs within 12 months after discharge was recorded, and patients were divided into the MACE group and the non-MACE group according to the occurrence of MACEs. The differences in proBNP and RDW-CV levels between the two groups were compared, and the factors influencing the occurrence of MACEs in HFpEF patients were analyzed. The predictive value of RDW-CV and proBNP for the occurrence of MACEs in HFpEF patients was assessed.Results Among the 106 HFpEF patients, 32 patients experienced MACEs, accounting for 30.19%. The RDW-CV and proBNP levels in the MACE group were higher than those in the non-MACE group (P < 0.05), and the hematocrit in the MACE group was lower than that in the non-MACE group (P < 0.05). The multivariable stepwise Logistic regression analysis revealed that low hematocrit [O^R = 0.242 (95% CI: 0.097, 0.606) ], high RDW-CV [O^R = 3.955 (95% CI: 1.595, 10.006) ], and high proBNP levels [O^R = 4.354 (95% CI: 1.738, 10.905) ] were identified as risk factors for the occurrence of MACEs in HFpEF patients (P < 0.05). ROC curve analysis showed that the sensitivities of RDW-CV, proBNP and their combination in predicting the occurrence of MACEs in HFpEF patients were 77.1% (95% CI: 0.683, 0.845), 83.5% (95% CI: 0.729, 0.921), and 91.4% (95% CI: 0.813, 0.996), with the specificities being 79.5% (95% CI: 0.701, 0.889), 65.3% (95% CI: 0.574, 0.712), and 61.4% (95% CI: 0.561, 0.709), respectively.Conclusion RDW-CV and proBNP are effective predictors for the occurrence of MACEs in HFpEF patients.