NT-proBNP、MPO和NLR联合超声心动图在老年瓣膜性心脏病患者恶性心律失常预测中的临床价值
Clinical value of NT-proBNP, MPO, and NLR combined with echocardiography in prediction of malignant arrhythmia in elderly patients with valvular heart disease.
作者信息
Liu Jianping, Zhou Apei, Zheng Meiduan, Wang Ling, Zeng Ping
机构信息
Department of Echocardiography, Quanzhou First Hospital, Quanzhou, Fujian, 362000, China.
Department of Gastroenterology, Quanzhou First Hospital, Quanzhou, Fujian, 362000, China.
出版信息
Perioper Med (Lond). 2025 Apr 22;14(1):44. doi: 10.1186/s13741-025-00527-7.
OBJECTIVE
We aimed to probe the clinical value of N-terminus pro-brain natriuretic peptide (NT-proBNP), myeloperoxidase (MPO), and neutrophil lymphocyte ratio (NLR) combined with echocardiography in the prediction of malignant arrhythmias (MA) in elderly patients with valvular heart disease (VHD).
METHODS
MPO, NT-proBNP, and NLR were detected in blood samples. After 1 year of follow-up, receiver operating characteristic curves were analyzed to determine the clinical value of NT-proBNP, MPO, NLR, and echocardiography for predicting MA in patients with VHD.
RESULTS
MPO, NT-proBNP, and NLR were higher in the VHD group. MPO, NT-proBNP, and NLR were higher with severe cardiac dysfunction. MPO, NT-proBNP, NLR, and LVESV in the MA group were higher. NT-proBNP was an independent factor influencing the occurrence of MA in elderly patients with VHD. The AUC for predicting MA in elderly patients with VHD using NT-proBNP, MPO, NLR, and echocardiography were 0.782 (sensitivity 61.50%, specificity 94.60%, 95% CI 0.630-0.934), 0.759 (sensitivity 69.20%, specificity 81.10%, 95% CI 0.579-0.938), 0.736 (sensitivity 76.90%, specificity 64.90%, 95% CI 0.562-0.910), and 0.782 (sensitivity 76.90%, specificity 75.70%, 95% CI 0.646-0.918), respectively. The AUC for the combined prediction using NT-proBNP, MPO, NLR, and echocardiography was 0.913 (sensitivity 76.90%, specificity 94.60%, 95% CI 0.820-1.000), higher than that of each parameter alone (P < 0.05).
CONCLUSION
The combination of NT-proBNP, MPO, NLR, and echocardiography has a predictive value in detecting MA in elderly VHD patients.
目的
我们旨在探讨N端前脑钠肽（NT-proBNP）、髓过氧化物酶（MPO）和中性粒细胞淋巴细胞比值（NLR）联合超声心动图在预测老年瓣膜性心脏病（VHD）患者恶性心律失常（MA）中的临床价值。
方法
检测血样中的MPO、NT-proBNP和NLR。随访1年后，分析受试者工作特征曲线以确定NT-proBNP、MPO、NLR和超声心动图对预测VHD患者MA的临床价值。
结果
VHD组的MPO、NT-proBNP和NLR较高。严重心脏功能不全时MPO、NT-proBNP和NLR更高。MA组的MPO、NT-proBNP、NLR和左室舒张末期容积（LVESV）更高。NT-proBNP是影响老年VHD患者发生MA的独立因素。使用NT-proBNP、MPO、NLR和超声心动图预测老年VHD患者MA的曲线下面积（AUC）分别为0.782（敏感性61.50%，特异性94.60%，95%可信区间0.630-0.934）、0.759（敏感性69.20%，特异性81.10%，95%可信区间0.579-0.938）、0.736（敏感性76.90%，特异性64.90%，95%可信区间0.562-0.910）和0.782（敏感性76.90%，特异性75.70%，95%可信区间0.646-0.918）。使用NT-proBNP、MPO、NLR和超声心动图联合预测的AUC为0.913（敏感性76.90%，特异性94.60%，95%可信区间0.820-1.000），高于各参数单独预测时（P<0.05）。
结论
NT-proBNP、MPO、NLR和超声心动图联合检测对老年VHD患者MA具有预测价值。
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