目的 探讨血清D-二聚体（D-D）、肌钙蛋白T（TNT）及B型脑钠肽前体（pro-BNP）在老年急性脑梗死伴脑心综合征中的预测价值。方法 选取2021-01至2023-12因急性脑梗死入院治疗的老年患者146例,根据是否发生脑心综合征分为脑心综合征组（56例）与无脑心综合征组（90例）。比较两组基线资料及相关实验室检查指标,采用多因素Logistic回归分析老年急性脑梗死患者发生脑心综合征的危险因素,采用ROC曲线分析D-D、TNT及pro-BNP对老年急性脑梗死患者发生脑心综合征的预测价值。结果 与无脑心综合征组比较,脑心综合征组年龄、高血压发生率、糖尿病发生率、D-D、TNT、CK-MB及pro-BNP水平明显较高,差异有统计学意义（P<0.05）。多因素Logistic回归分析显示,年龄、高血压、D-D、TNT及pro-BNP是老年急性脑梗死并发脑心综合征的独立危险因素。以2.05 mg/L作为血清D-D的临界值,ROC曲线下面积为0.717,预测敏感度为68.7%,特异度为87.2% ;以38.41 ng/L作为血清TNT的临界值,ROC曲线下面积为0.799,预测敏感度为90.5%,特异度为60.3% ;以1268.36 pg/ml作为血清pro-BNP的临界值, ROC曲线下面积为0.743,预测敏感度为81.3%,特异度为62.7% ;三者联合ROC曲线下面积为0.825,预测敏感度为72.0%,特异度为83.3%。结论 血清D-D、TNT及pro-BNP水平升高是老年急性脑梗死并发脑心综合征的危险因素,对脑心综合征的发生具有预测价值。
Abstract
Objective To investigate the predictive value of serum D-dimer （D-D）, troponin T （TNT） and B-type brain natriuretic peptide precursor （pro-BNP） in elderly patients with acute cerebral infarction accompanied by cerebrocardiac syndrome. Methods A total of 146 elderly patients with acute cerebral infarction from January 2022 to December 2023 were selected and divided into a cerebrocardiac syndrome group （56 cases） and non-cerebrocardiac syndrome group （90 cases） according to whether they developed cerebrocardiac syndrome. The baseline data and relevant laboratory examination indicators of the two groups were compared. Risk factors of cerebrocardiac syndrome in the patients were analyzed by multivariate Logistic regression,and the predictive value of D-D, TNT and pro-BNP was analyzed by ROC curve. Results Compared with non-cerebrocardiac syndrome group, the age, incidence of hypertension, incidence of diabetes, D-D, TNT, CK-MB and pro-BNP levels in the cerebrocardiac syndrome group were significantly higherr, with statistically significant differences （P<0.05）. Multivariate Logistic regression analysis showed that age, hypertension, D-D,TNT and pro-BNP were independent risk factors for the occurrence of cerebrocardiac syndrome in elderly patients with acute cerebral infarction. Using 2.05mg/L as the critical value of serum D-D,the area under ROC curve was 0.717, the predicted sensitivity was 68.7%, and the specificity was 87.2%. Using38.41ng/L as the critical value of serum TNT,the area under ROC curve was 0.799,the sensitivity was 90.5%, and the specificity was 60.3%. Taking 1268.36pg/mL as the critical value of serum pro-BNP, the area under ROC curve was 0.743, the sensitivity was 81.3%, and the specificity was 62.7%. The area under the combined ROC curve was 0.825, the sensitivity was 72.0%,and the specificity was 83.3%. Conclusions Elevated levels of serum D-D, TNT and pro-BNP are one of the risk factors of acute cerebral infarction complicated with cerebrocardiac syndrome in the elderly,which are characterized by predictive value for the occurrence of cerebrocardiac syndrome.
关键词
D-二聚体 /
肌钙蛋白T /
B型脑钠肽前体 /
急性脑梗死 /
脑心综合征
Key words
D-dimer /
troponin T /
B-type brain natriuretic peptide precursor /
acute cerebral infarction /
cerebrocardiac syndrome
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