Abstract: Objective　To explore the relationship between the levels of serum cTnI, NT-proBNP, and uric acid and the prognosis of patients with acute heart failure. Methods　Eighty patients with acute heart failure were selected from Department of Cardiovascular Medicine, The Fourth Affiliated Hospital of Guangzhou Medical University from September 2020 to September 2021. The patients' general clinical data were recorded, and they were followed up for half a year. According to the occurrence of cardiovascular and cerebrovascular diseases in the past six months, the patients were divided into a poor prognosis group (35 cases; with cardiovascular and cerebrovascular diseases), including 19 males and 16 females who were (72.11±4.23) years old, and a good prognosis group (45 cases; without cardiovascular and cerebrovascular diseases), including 24 males and 21 females who were (72.67±4.28) years old. The influencing factors of prognosis were analyzed, and the predictive values of single and combined levels of serum cTnI, NT-proBNP, and uric acid on prognosis were analyzed. t test was used for the measurement data of normal distribution, and rank-sum test for the measurement data not of normal distribution. Results　There were no statistical differences in the general clinical data between the two groups (all P>0.05). The serum levels of CTnI, NT-proBNP, and uric acid in the poor prognosis group were significantly higher than those in the good prognosis group (all P<0.05). The independent influencing factors in the poor prognosis group included serum NT-proBNP and uric acid levels. The predictive efficacy of serum cTnI for poor prognosis was as below: area under curve (AUC) was 0.757, sensitivity 0.657, and specificity 0.822. The AUC, sensitivity, and specificity of serum NT-proBNP for poor prognosis were 0.980, 0.943, and 0.956. The AUC, sensitivity, and specificity of serum uric acid level for poor prognosis were 0.830, 0.943, and 0.578, respectively. The AUC, sensitivity, and specificity of the combination of the three indicators for poor prognosis were 0.996, 0.971, and 0.956. Conclusions　The levels of serum cTnI, NT-proBNP, and uric acid in patients with poor prognosis are significantly higher than those in patients with good prognosis. The levels of serum NT-proBNP and uric acid are independent influencing factors of poor prognosis. The three indicators can accurately predict the prognosis of patients with acute heart failure, and the combination of them has the highest predictive value for their prognosis.

Key words: Acute heart failure, Cardiac troponin I, N-terminal pro-brain natriuretic peptide, Uric acid, Prognosis

摘要： 目的　探究急性心力衰竭患者血清心肌肌钙蛋白I（cTnI）、N-末端脑钠肽前体（NT-proBNP）、尿酸水平与患者的预后效果的关系。方法　选取广州医科大学附属第四医院心血管内科于2020年9月至2021年9月收治的急性心力衰竭患者80例，记录患者的临床一般资料并对其进行为期半年的随访，以患者这半年内心脑血管疾病发生情况将患者分为两组：预后不良组（发生心脑血管疾病）35例，男19例，女16例，年龄（72.11±4.23）岁；预后良好组（未发生心脑血管疾病）45例，男24例，女21例，年龄（72.67±4.28）岁。对两组预后效果的影响因素进行分析，并针对血清cTnI、NT-proBNP、尿酸水平单一以及联合对预后效果的预测价值进行分析。正态定量资料采用t检验，非正态的定量资料采用秩和检验进行分析。结果　两组患者的临床一般资料无明显差异（P>0.05）。临床预后不良患者的血清cTnI、NT-proBNP以及尿酸水平均显著高于预后效果好的患者（均P<0.05）。急性心力衰竭患者预后不良的独立影响因素包括血清NT-proBNP以及尿酸水平。血清cTnI对预后不良的预测效能：曲线下面积（AUC）为0.757，灵敏度为0.657，特异度为0.822；血清NT-proBNP对预后不良的预测效能上述指标分别为0.980，0.943，0.956；血清尿酸水平对预后不良的预测效能上述指标分别为0.830，0.943，0.578；而三组指标联合对预后不良的预测效能的上述指标为0.996，0.971，0.956。结论　预后不良患者的血清cTnI、NT-proBNP以及尿酸水平均显著高于预后效果好的患者，且血清NT-proBNP以及尿酸水平是预后效果不良的独立影响因素，同时三者均能对急性心力衰竭患者的预后做出较为准确的预测，且三者联合时对急性心力衰竭患者预后的预测价值最高。

关键词: 急性心力衰竭, 心肌肌钙蛋白I, N末端脑钠肽前体, 尿酸, 预后