【摘要】 目的评估≥75岁新型冠状病毒肺炎(coronavirus infectious disease 2019,COVID-19)患者心肌损伤标志物与氨基末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)对预后的预测价值。方法纳入武汉市第一医院收治的141例≥75岁COVID-19患者,分析入院时乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、超敏肌钙蛋白I(hs-TnI)和NT-proBNP与预后的相关性。结果 141例患者死亡18例(12.8%),男性11例(61.1%)。与出院组比较,死亡组患者LDH>250 IU/L(77.8%)、hs-TnI> 26 ng/L(72.2%)、NT-proBNP> 1 800 ng/L(72.2%)的比例较高(P <0.05)。受试者工作特征(ROC)曲线分析,NT-proBNP曲线下面积最大(0.94),hs-TnI次之(0.88)。当NT-proBNP为1 025 ng/L时,对COVID-19患者发生院内死亡有较好的预测价值。结论老年COVID-19患者心肌损伤及NT-proBNP水平升高常见,且NT-proBNP对预后具有较好的预测价值。更多还原

【Abstract】 Objective To unveil the prognostic effect of myocardial injury markers and NT-proBNP on patients aged ≥ 75 years with coronavirus disease-19(COVID-19).Methods A total of 141 consecutive patients aged ≥75 years who were admitted to the hospital between 12th and 19th February 2020.In-hospital death,clinical characteristics and myocardial injury markers and NT-proBNP on admission were obtained from medical records.The association of myocardial markers evaluated by LDH,CK,CK-MB,AST,ALT,hs-TnI,and NT-proBNP were collected.Results 18(12.8%) patients died,including 11(61.1%) male and 7(38.9%) female.Patients with elevated level of LDH,hs-TnI,and NT-proBNP had significantly higher risk of death than those in discharged group(P <0.05).ROC curve analysis showed that the area under curves of NT-proBNP was the highest(0.94),followed by hs-TnI(0.88).When the cutoff value of NT-proBNP was 1 025 ng/L,the positive predictive value was 94.40%,the negative predictive value was 89.40%.Conclusions Myocardial injury and elevated NT-proBNP levels are common in elderly patients with COVID-19,and NT-proBNP has a good predictive value for prognosis.更多还原