Value of serum albumin level in prediction of degree of heart function failure and risk of sudden death in patients with dilated cardiomyopathy
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摘要: 目的 分析血清白蛋白水平与扩张型心肌病患者心功能衰竭程度的关系及对猝死风险的预测价值。 方法 选取216例扩张型心肌病患者作为研究对象,根据美国纽约心脏病协会(NYHA)心功能分级分为Ⅰ~Ⅱ级组124例和Ⅲ~Ⅳ级组92例,比较2组一般资料及血清白蛋白水平,对相关因素进行Pearson相关性分析;随访24个月,观察猝死发生情况,采用多因素Logistic回归分析猝死的独立预测因素,以受试者工作特征(ROC)曲线下面积(AUC)定量评价血清白蛋白水平对猝死风险的预测效能。 结果 2组左心房内径、左心室舒张末内径、左心室射血分数和血清白蛋白水平比较,差异均有统计学意义(P<0.05或P<0.01); Pearson相关性分析显示,扩张型心肌病患者血清白蛋白水平与左心房内径、左心室舒张末内径均呈负相关(r=-0.384、-0.457, P<0.001), 与左心室射血分数呈正相关(r=0.518, P<0.001); 所有患者均获得随访,共发生猝死46例; 多因素Logistic回归分析显示,左心室射血分数和血清白蛋白均是扩张型心肌病患者发生猝死的独立预测因素(P<0.05); 经ROC曲线分析,血清白蛋白预测扩张型心肌病患者发生猝死的AUC为0.924, 大于左心室射血分数的0.738, 差异有统计学意义(P=0.016)。 结论 血清白蛋白水平与扩张型心肌病患者心功能衰竭程度呈负相关,其预测猝死风险的效能较高。Abstract: Objective To analyze the relationship between serum albumin level and the degree of heart function failure in patients with dilated cardiomyopathy and its value in prediction of risk of sudden death. Methods A total of 216 patients with dilated cardiomyopathy were selected as research objects, and were divided into Ⅰ to Ⅱ grading group(n=124)and Ⅲ to Ⅳ grading group(n=92)grading of cardiac function of New York Heart Association(NYHA). The general data and serum albumin levels of the two groups were analyzed. The related factors were analyzed by Pearson correlation analysis, the patients were followed up for 24 months, and the incidence rate of sudden death was observed. Multivariate Logistic regression was performed to analyze the independent predictive factors of sudden death. Area under the curve(AUC)of the receiver's working characteristics(ROC)was used to quantitatively evaluate the efficacy of serum albumin levels in prediction of the risk of sudden death. Results There were significant differences in the left atrial inner diameter, left ventricular end-diastolic inner diameter, left ventricular ejection fraction and serum albumin level between two groups(P<0.05 or P<0.01). Pearson correlation analysis showed that serum albumin levels in patients with dilated cardiomyopathy were negatively correlated with the left atrium diameter and the left ventricular end-diastolic diameter(r=-0.384, -0.457, P<0.001), and were positively - correlated with the left ventricular ejection fraction(r=0.518, P<0.001). All patients were followed up successfully, and a total of 46 sudden death cases were found. Logistic multivariate regression analysis showed that left ventricular ejection fraction and serum albumin were independent predictors of sudden death in patients with dilated cardiomyopathy(P<0.05); ROC curve analysis showed that AUC of serum albumin in prediction of sudden death in patients with dilated cardiomyopathy was 0.924, which was significantly higher than 0.738 of left ventricular ejection fraction, the difference was statistically significant(P<0.05). Conclusion Serum albumin level is negatively correlated with degree of heart function failure in patients with dilated cardiomyopathy, and has higher effectiveness in predicting the risk of sudden death.
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