西安地区血浆BNP正常值的建立及在不同疾病中诊断截断点的研究

Normal Value Range of Plasma Brain Natriuretic Peptide(BNP) and Study on Diagnosis Cut-off Point of BNP Levels in Various Disease from Xi'an Area

目的建立西安地区健康人群血浆脑钠肽（BNP）的正常值范围，观察其在心、肺、糖尿病以及肾脏疾患中的改变及诊断截断点，探讨将BNP作为上述疾病临床诊断和治疗效果的标志物的可靠性。方法采用微粒子酶免分析法，对西安地区健康人群血浆样本258份，不同疾病的住院患者血浆372份，进行血浆BNP浓度检测。结果西安地区健康人群血浆BNP的正常值范围（微粒子酶免分析法）0～38pg／ml；血浆BNP浓度在糖尿病组、冠心病组、心肌梗死组、心衰组、肾病组和肺病组中的诊断截断点分别为38．94，46．70，71．95，115．69，80．17和66．35pg／ml，不同心血管疾病组与正常组BNP浓度差异均有非常显著性（P〈0．01）；肾脏疾病组与正常组BNP浓度差异显著（P〈0．05）；而糖尿病组、肺病组则显示无统计学意义。结论建立地区健康人群血浆BNP的正常值范围，对于当地患者相关疾病的诊断具有重要实用价值；诊断截断点的建立可提高对疾病诊断的准确率。血浆BNP浓度不仅是心衰的强预报因子，而且在其它心脏疾患及肾脏病变中均显著升高，进一步显示了其在心、肾疾病诊断和治疗中潜在的临床价值。

Objective To investigate the plasma brain natriuretic peptide（BNP）levels in health adults from Xian area. Observation the change and cut-off point of BNP levels in cardiac disease,pulmonary disease,diabetes mellitus and nephrosis, Study the clinical value of BNP as a potential marker for clinical diagnosis and therapeutic efficacy. Methods 258 plasma samples （132 male, 126 female）from health examination crowd had been selected to measured BNP levels by microparticle enzyme immunoassay since Mar-Nov. 2004. In the same,372 patients were selected from inpatients in Xijing hospital to detect their BNP concentration, Comparing the significant difference of BNP levels between patients groups with normal group, Rusults The BNP levels in health adults were 0-38 pg/ml The diagnosis cut-off point of BNP concentartion in coronary heart disease,myocardial infarction,heart failure were of BNP concentration in diabetes mellitus,coronary heart disease ,myocardial infarction ,heart failure, nephrosis and pulmonary disease patients was 38, 94 pg/ml, 46.70 pg/ml, 71, 95 pg/ml, 115. 69 pg/ml, 80. 17pg/ml and 66. 35pg/ml, respectively, There were significant differences in BNP levels among patients groups with normal group（P〈0. 01）, There were difference among nephrosis group with normal group （P〈0.05）, There were no difference in BNP levels among patients groups diabetes mellitus and pulmonary disease patients with health adults normal group. Conclusion Normal value range of plasma brain natriuretic peptide （BNP）can use to make a definite diagnosis, Measuring of diagnosis cut-off point of BNP levels might be used to make definite diagnosis, The BNP concentration in patients with cardiac disease include coronary heart disease, cardiac angina, myocardial infarction, heart failure and nephrosis etc were obviously higher than health adults （P〈0.05）, So measuring of plasma BNP levels might be a potential benefits as markers of cardiac injury or nephrosis and response to therapy.