急诊急性心力衰竭患者入院时NT-proBNP水平与短期预后的相关性分析

Correlation Analysis of NT-proBNP Levels at Admission and Short-Term Prognosis in Patients with Acute Heart Failure in the Emergency Department

摘要: 目的：探讨急诊急性心力衰竭(AHF)患者入院时N末端B型利钠肽前体(NT-proBNP)水平与短期预后的相关性，为急诊早期风险识别和治疗决策提供参考依据。方法：回顾性分析2022年1月至2025年12月珠海市中西医结合医院急诊科收治的76例AHF患者，按入院时NT-proBNP中位数(5548 pg/mL)分为高NT-proBNP组(>5548 pg/mL，28例)和低NT-proBNP组(≤5548 pg/mL，48例)。比较两组住院时间、NT-proBNP治疗反应率、左室射血分数(LVEF)改善值及NYHA心功能分级改善情况，并采用多因素Logistic回归分析NT-proBNP对预后的预测价值。结果：高NT-proBNP组慢性肾脏病(53.57% vs 25.00%, P < 0.05)和瓣膜病(21.43% vs 4.17%, P < 0.05)比例更高，血清肌酐水平更高[(152.29 ± 92.30) μmol/L vs (97.42 ± 45.82) μmol/L, P < 0.001]。两组住院时间、NT-proBNP治疗反应良好率、LVEF改善值及NYHA心功能分级改善率差异均无统计学意义(P > 0.05)。多因素Logistic回归分析显示，年龄是住院时间延长的独立预测因素(OR = 1.061, 95%CI: 1.020~1.105, P = 0.004)，NT-proBNP分组未显示出独立预测价值(P > 0.05)。结论：在急诊AHF患者中，入院时NT-proBNP水平与短期预后指标未显示显著相关性，其对住院时间、治疗反应及心功能改善的独立预测价值有限，临床评估仍需结合年龄等因素综合判断。

Abstract: Objective: This paper aims to explore the correlation between the N-terminal pro-B-type natriuretic peptide (NT-proBNP) level at admission and the short-term prognosis of patients with acute heart failure (AHF) in the emergency department, and to provide a reference for early risk identification and treatment decisions in the emergency setting. Methods: A retrospective analysis was conducted on 76 patients with AHF admitted to the emergency department of Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to December 2025. The patients were divided into the high NT-proBNP group (>5548 pg/mL, 28 cases) and the low NT-proBNP group (≤5548 pg/mL, 48 cases) based on the median NT-proBNP level at admission (5548 pg/mL). The hospitalization time, NT-proBNP treatment response rate, improvement value of left ventricular ejection fraction (LVEF), and improvement of NYHA cardiac function classification were compared between the two groups. Multivariate Logistic regression analysis was used to evaluate the predictive value of NT-proBNP for prognosis. Results: The high NT-proBNP group had a higher proportion of chronic kidney disease (53.57% vs 25.00%, P < 0.05) and valvular disease (21.43% vs 4.17%, P < 0.05), and a higher serum creatinine level [(152.29 ± 92.30) μmol/L vs (97.42 ± 45.82) μmol/L, P < 0.001]. There were no statistically significant differences in hospitalization time, good treatment response rate of NT-proBNP, improvement value of LVEF, and improvement rate of NYHA cardiac function classification between the two groups (P > 0.05). Multivariate Logistic regression analysis showed that age was an independent predictor of prolonged hospitalization time (OR = 1.061, 95%CI: 1.020~1.105, P = 0.004), and NT-proBNP grouping did not show independent predictive value (P > 0.05). Conclusion: In patients with AHF in the emergency department, the NT-proBNP level at admission did not show a significant correlation with short-term prognosis indicators. Its independent predictive value for hospitalization time, treatment response, and improvement of cardiac function is limited. Clinical assessment still needs to be comprehensively judged by combining factors such as age.