摘要目的 探讨血清总胆汁酸(total bile acid, TBA)及N末端B型钠尿肽原(N terminal pro B type natriuretic peptide, NT-proBNP)在慢性心力衰竭(chronic heart failure, CHF)合并2型糖尿病(type 2 diabetes,T2DM)患者预后评估中的应用价值。方法 选取2019-10至2020-06在北京电力医院住院CHF患者146例,根据是否合并T2DM,分为观察组(87例)及对照组(59例)。分别检测各组TBA及NT-proBNP水平,通过ROC曲线分析TBA、NT-proBNP及两者联合检测在CHF合并T2DM患者预后评估中的临床价值。结果 与对照组相比,TBA和NT-proBNP水平在观察组中均呈明显升高趋势(P<0.01)。Spearmen等级相关分析显示,观察组心功能分级与TBA水平呈正相关(rs=0.633,P<0.01);Pearson相关分析显示,观察组TBA水平与NT-proBNP水平呈正相关(r=0.539,P<0.01);ROC曲线分析显示血清TBA+NT-proBNP联合检测的ROC曲线下面积明显高于TBA和NT-proBNP(0.942 vs. 0.728和0.912,P<0.05)。结论 血清TBA水平在CHF合并T2DM患者中明显升高,且与心功能分级呈正相关;血清TBA、NT-proBNP水平对CHF合并T2DM患者的预后具有良好的预测价值,联合检测更优。
Abstract：Objective To study the applicability of serum total bile acid (TBA) and N terminal pro B type natriuretic peptide (NT-proBNP) in the assessment of prognosis of patients with chronic heart failure (CHF) complicated with type 2 diabetes (T2DM). Methods A total of 146 CHF patients hospitalized in Beijing Electric Power Hospital between October 2019 and June 2020 were selected and divided into the observation group (n=87) and control group (n=59) according to complications with T2DM. The levels of TBA and NT-proBNP in each group were detected, and the clinical value of TBA, NT-proBNP, and their combined detection in the prognosis assessment of CHF patients with T2DM was analyzed respectively by the ROC curve. Results Compared with the control group, the levels of TBA and NT-proBNP in the observation group were significantly increased (P<0.01). Spearmen grade correlation analysis showed that the cardiac function grade in the observation group was positively correlated with TBA levels (rs=0.633, P<0.01). Pearson correlation analysis showed that the level of TBA in the observation group was positively correlated with the level of NT-proBNP (r=0.539, P<0.01). ROC curve analysis showed that the area under the ROC curve with serum TBA+NT-proBNP combined detection was significantly larger than that of TBA and NT-proBNP used alone(0.942 vs. 0.728 and 0.912, P<0.05). Conclusions Serum TBA levels are significantly increased in CHF patients with T2DM and are positively correlated with cardiac function classification. Serum TBA and NT-proBNP levels can help predict the prognosis of CHF patients with T2DM, and combined detection is better.
俞泓, 张蛟, 张璐, 荆丽敏. 血清总胆汁酸及N末端B型钠尿肽原在慢性心力衰竭合并2型糖尿病患者预后评估中的应用价值[J]. 武警医学, 2021, 32(11): 977-980.
YU Hong, ZHANG Jiao, ZHANG Lu, JING Limin. Applicability of serum total bile acid and NT-proBNP levels in prognostic evaluation of patients with chronic heart failure and type 2 diabetes. Med. J. Chin. Peop. Armed Poli. Forc., 2021, 32(11): 977-980.
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2021, Vol. 32 
