B型钠尿肽在心功能评价及慢性充血性心力衰竭诊断中的应用价值

Value of BNP in the Evaluation of Cardiac Function and Diagnosis of Congestive Heart Failure

目的:研究B型钠尿肽(BNP)对心功能的评价作用及其在诊断慢性充血性心力衰竭中的应用价值。方法:选择慢性心衰患者152例,正常对照组48例,测定血清BNP浓度、LVEF等指标,分析其相关性。结果:心衰组BNP水平显著高于对照组(P<0.01),NYHA分级与BNP呈显著正相关(r=0.823,P<0.01),LVEF与BNP呈显著负相关(r=-0.652,P<0.01)。ROC曲线分析,BNP诊断心衰和左室收缩功能不全的诊断界值分别为100ng/L和580ng/L,此时诊断心衰和左室收缩功能不全的灵敏度和特异度分别为78%、98%和92.5%、88.5%;诊断心衰的阳性预测值为98%,阴性预测值为62%。结论:BNP可以客观准确评价心功能,对心衰及左室收缩功能不全的诊断具有理想的灵敏度和特异度,可作为诊断心衰的实验室指标之一,值得临床推广应用。

Objective： To investigate the value of BNP in the evaluation of cardiac function and the diagnosis of congestive heart failure. Methods： 48 healthy controls and 152 patients with congestive heart failure were selected. The concentration of BNP and left ventricular ejection fraction （LVEF）were measured. The relationships between the concentration of BNP and LVEF were analyzed. Results： Serum BNP are significantly higher in heart failure patients compared with healthy controls （P 〈 0.01）. BNP showed positive correlation with NYHA classification （r=0.823,P 〈 0.01） and negative correlation with LVEF（r=-0.652,P 〈 0.01）. When cutoff value was 100 ng/L for heart failure and 580 ng/L for left ventricular systolic dysfunction, sensitivity and specificity were 78% ,98% and 92.5% ,88.5%, respectively. With cutoff value of 100 ng/L, positive predictive value and negative predictive value for BNP were 98% and 62% to detect heart failure. Conclusion： BNP is a valuable biomarker for the evaluation of cardiac function and the diagnosis of heart failure as well as left ventricular systolic dysfunction for its high sensitivity and specificity.