重度心力衰竭患者血清 RDW、CPP、NT-proANP 的临床意义 及其与预后相关性分析.

Objective: To investigate the clinical significance of serum red blood cell distribution width (RDW), cardiac peptide peptide (CPP) and amino-terminal type A natriuretic peptide (NT-proANP) in patients with severe heart failure and their correlation with prognosis. Methods: 98 patients with heart failure admitted to our hospital from January 2020 to December 2023 were selected as the study subjects. All patients were divided into groups according to Killip classification, including 16 patients with grade I, 23 patients with grade II, 21 patients with grade III, and 38 patients with grade IV. 50 healthy volunteers who came to our hospital for physical examination at the same time were selected as the control group. The expression levels of serum RDW, CPP, and NT-proANP in five groups were compared, and the correlation between RDW, CPP, NT-proANP and severe heart failure was analyzed. Subsequently, 59 patients with severe heart failure of grade III and IV were divided into death group(n=21) and survival group(n=38) according to their prognosis. The clinical general situation and the expression level of serum RDW, CPP, NT-proANP were compared between the two groups, and the prognostic value of serum RDW, CPP, NT-proANP for severe heart failure was analyzed. Results: The levels of serum RDW, CPP and NT-proANP were significantly different among the five groups. The level of serum RDW, CPP and NT-proANP in grade IV group was significantly higher than that in grade III, II, I and control group(P<0.05); Spearman correlation analysis showed that serum RDW, CPP, NT-proANP were positively correlated with severe heart failure (P<0.05); The area under the curve (AUC) is RDW (0.688), CPP (0.667), NT-proANP (0.656), and the combination of the three (0.671). The diagnostic sensitivity of RDW is 67.61 %, the specificity is 66.85%, the diagnostic sensitivity of CPP is 60.03 %, the specificity is 67.53 %, the diagnostic sensitivity of NT-proANP is 61.24 %, the specificity is 66.53%, the combined diagnostic sensitivity of the three is 74.58 %, the specificity is 86.32 %; There were significant differences in Killip grade, levels of RDW, CPP, NT proANP between the survival group and the death group(P<0.05); The results of logistic regression analysis showed that RDW, CPP and NT-proANP were independent predictors of the prognosis of severe heart failure(P<0.05). Conclusion: Serum RDW, CPP and NT-proANP are significantly correlated with severe heart failure, and their diagnostic thresholds for severe heart failure are 17.58 %, 1772.62 pg/mL and 1.12 nmol/mL, respectively. At the same time, the three factors are independent influencing factors for poor prognosis of severe heart failure. [ABSTRACT FROM AUTHOR]