NT-proBNP对慢性心力衰竭患者的诊断价值研究

Study of diagnostic value of NT-proBNP in patients with coronary heart failure

关键词:  氮端前脑钠肽  慢性心力衰竭  诊断

Key words:  N-terminal pro B-type natriuretic peptide(NT-proBNP)  chronic heart failure (CHF)  diagnosis

摘要:

［目的］探讨NT-proBNP对慢性心力衰竭（CHF）患者的诊断价值。［方法］36例CHF患者，采用间接竞争ELISA方法测定血清中NT-proBNP浓度。［结果］①心功能失代偿和代偿CHF患者NT-proBNP水平分别为(304.81±102.30)fmol/mL和(198.30±75.06)fmol/mL，P=0.01；重度和轻-中度CHF患者NT-proBNP水平分别为(392.97±101.59)fmol/mL和(255.84±63.60)fmol/mL，P＜0.001；NT-proBNP和NYHA分级的相关系数为0.65，P＜0.001；NT-proBNP诊断心功能失代偿患者敏感度达0.64，特异度达0.88。②有、无收缩功能不全的CHF患者NT-proBNP水平分别为(344.12± 94.87)fmol/mL和(249.66±98.04)fmol/mL，P=0.01；有、无舒张功能不全的CHF患者血清NT-proBNP浓度分别为(299.77±88.66)fmol/mL和(205.99±61.61)fmol/mL，P=0.004；NT-proBNP和LVEF相关系数为-0.39，P=0.02；NT-proBNP和EPSS相关系数为0.54，P=0.002；NT-proBNP诊断收缩性CHF患者的敏感度为0.37，特异度为0.30；诊断舒张性CHF患者的敏感度为0.71，特异度为0.83。［结论］NT-proBNP可作为评定CHF程度的指标，并且有可能成为诊断心脏舒张功能不全的良好指标。

Abstract:

［Objective］To evaluate the value of NT-proBNP in the diagnosis of chronic heart failure(CHF).［Methods］NT-proBNP concentration were measured by an ELISA method in chronic heart failure patients (n=36), compared with NYHA class, LVEF, EPSS, and analyzed by ROC method.［Results］① Serum NT-proBNP concentration in the compensate and decompensate heart failure patients were (198.30±75.06) fmol/mL and (304.81±102.30) fmol/mL, P<0.05; in the moderate and severe were (255.84±63.60) fmol/mL and (392.97±101.59) fmol/mL, P<0.05; Serum NT-proBNP concentration was correlated with NYHA classification, r_s=0.65, P<0.001; The sensitivity and specificity for NT-proBNP diagnosing decompensate heart failure patients were 0.64 and 0.88. ② Serum NT-proBNP concentration in the patients with and without systolic dysfunction were (344.12±94.87) fmol/mL and (249.66±98.04) fmol/mL, P<0.05; in the patients with and without diastolic dysfunction were fmol/mL 299.77±88.66 and (205.99±61.61) fmol/mL, P=0.004; Serum NT-proBNP concentration was correlated with LVEF (r_s=-0.39, P=0.020) and EPSS(r_s=0.54, P=0.002); Area under the ROC curve (AUC) for the systolic and the diastolic heart failure were 0.74 (0.020) and 0.80 (0.007) respectively.［Conclusion］NT-proBNP can be very useful for evaluating the severity of chronic heart failure and may be valuable for the diagnosis of diastolic heart failure.