化学发光免疫分析法检测B型钠尿肽在心力衰竭诊断中的价值

Value of chemiluminescence immunoassay in BNP detection for heart failure laboratory diagnosis

目的 建立简便可靠的血浆B型钠尿肽（BNP）检测方法，探讨BNP测定在心力衰竭诊断中的应用价值。方法 采用直接化学发光技术进行的全自动双抗体夹心免疫测定方法，测定110例正常人和95例心功能Ⅰ～Ⅳ级心力衰竭患者血浆BNP含量。结果 本法测定BNP的灵敏度为2.0pg／ml，检测范围上限可达5000pg／ml，批内CV平均为2．7％，批间CV平均为4．2％，平均回收率为97％。健康对照组（n=110）、心功能Ⅰ级组（n=30）、心功能Ⅱ级组（n=30）、心功能Ⅲ～Ⅳ级组（n=35）各组血浆BNP浓度分别为（27．3±16．7）、（88．7±40．7）、（285．0±92．0）和（862．0±355．0）pg／ml；心衰各组BNP水平显著高于健康对照组（P〈0．001）。以BNP100pg／ml为临界值，诊断心力衰竭的特异性为99．1％，敏感度为84．2％。结论 化学发光免疫分析法检测血浆BNP，操作简便，敏感度高，特异性强，适合于临床推广。BNP是一个很好的评价心衰患者心功能状态的实验室指标。

Objective To develop a credible and simple detection of B-type natriuretic peptide （BNP） and to probe into the value of BNP detection in heart failure laboratory diagnosis. Methods To apply a completely automatic two-side ＂sandwich＂ immunoassay, which was carried out by the direct technology of chemiluminescence to detect the concentration of plasma BNP. Then to detect and analyze the BNP levels of healthy people （n= 110） and heart failure （ Ⅰ-Ⅳ ） patients （n= 95）. Results The lowest detection level were 2.0pg/ml; the upper limit of the detection could reach 5 000pg/ml. The CVs of inter- and intra- assay were 2.70% and 4.20%, respectively. The mean recovery rate was 97%. The mean levels of plasma BNP concentration in healthy controls （n= 110）, heart failure patients class Ⅰ （n=30） classⅡ （n=30） classⅢ-Ⅳ （n= 35）were（27.3±16.7） ,（88.7±40.7） ,（285.0± 92.0）and（862.0± 355.0） pg/ml, respectively. BNP levels in the heart failure groups were significantly higher than that in healthy controls （P〈0. 001）. Its sensitivity and specificity for the diagnosis of heart failure were 99.1% and 84.2% with a cutoff value of 100 pg/ml. Conclusion Using chemiluminescence immunoassay to detect plasma BNP is conducive to clinical promotion which is characterized by easy operation,high sensitivity and strong specificity. BNP is a good laboratory test for evaluating heart function of the patients with heart failure.