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目的探讨血小板平均体积(mean platelet volume,MPV)与冠心病心衰患者预后的相关性,同时评价MPV是否可以提供独立于N末端B型钠尿肽原(N-terminal pro-brain natriuretic peptide,NT-pro BNP)以外的预后信息。方法选择阜外医院因冠心病心衰的住院患者503例,记录他们入院时的NT-pro BNP、MPV、左室射血分数(left ventricular ejection fraction,LVEF)以及其他临床指标。随访患者住院期间和出院后的死亡及再住院情况。结果中位随访693天后,230例发生再住院和死亡事件。多变量分析可以看出,MPV是冠心病心衰预后的独立危险因素[HR:1.220(1.048,1.419),P=0.017];在Kaplan-Meier分析中,将受试者以MPV、NT-pro BNP中位数为分界线分2组,发现MPV、NT-pro BNP低于中位数组的生存率显著高于MPV、NT-pro BNP高于中位数组,COX风险回归模型显示,MPV>10.3%且NT-pro BNP>1248.4fmol/m L组发生终点事件的风险比为4组中最高[HR:7.32(4.37,17.52)]。结论联合MPV和NT-pro BNP检测可以提高单独检测NT-pro BNP对心衰患者死亡的预测价值,提供独立于NT-pro BNP以外的预测信息。
Objective To investigate the relationship between the mean platelet volume (MPV) and the prognosis of patients with coronary heart disease (CHF) and to evaluate whether MPV can provide an independent N-terminal pro-brain natriuretic peptide (NT) -pro BNP). Methods A total of 503 hospitalized patients with heart failure due to coronary heart disease were enrolled in this study. NT-pro BNP, MPV, left ventricular ejection fraction (LVEF) and other clinical parameters were recorded. Patients were followed up during hospitalization and after hospital discharge and rehospitalization. Results After a median follow-up of 693 days, there were 230 rehospitalization and deaths. Multivariate analysis showed that MPV was an independent risk factor for the prognosis of CHF (HR: 1.220 (1.048, 1.419), P = 0.017). In the Kaplan-Meier analysis, subjects were treated with MPV, NT-pro The median BNP was divided into two groups. It was found that the survival rates of MPV and NT-pro BNP lower than the median group were significantly higher than those of MPV and NT-pro BNP were higher than the median. The COX risk regression model showed that MPV> 10.3 % And the risk ratio of endpoint events in NT-pro BNP> 1248.4fmol / m L group was the highest among the four groups [HR: 7.32 (4.37, 17.52)]. Conclusion Combined MPV and NT-pro BNP testing may improve the predictive value of NT-pro BNP alone in the assessment of death in patients with heart failure and provide predictive information independent of NT-pro BNP.