无器质性心脏病者血浆N末端B型利钠肽原浓度及其影响因素

Plasma N-terminal pro-B-type natriuretic peptide reference value in subjects without heart diseases

目的探讨成年人血浆N末端B型利钠肽原（NT—proBNP）的正常参考值范围及影响因素。方法选择常规临床检查和冠状动脉造影正常的成年人300例，用酶联免疫吸附法检测血浆NT-proBNP浓度。以每10岁为一个年龄组，比较各年龄组间和相同年龄组的男女间血浆NT—proBNP浓度的差异，并分别比较有与无高血压病、糖尿病及超重者的血浆NT—proBNP浓度。用多元逐步回归分析方法，分析血浆NT—proBNP浓度的影响因素。并计算血浆NT-proBNP浓度的正常参考值。结果在正常成年人，血浆NT—proBNP浓度在男性60岁以上者随年龄升高而升高（P〈0．05），而在男性60岁以下者和女性则不随年龄变化而变化（均P〉0．05）。男女间比较，血浆NT—proBNP浓度在60岁以下女性高于男性（P〈0．05），而60岁以上则男性高于女性（P〈0．05）。有与无高血压病、糖尿病及超重者间分别比较血浆NT-proBNP浓度均无统计学差异（均P〉0．05）。多元逐步回归分析表明，年龄是血浆NT—proBNP浓度的独立预测因素（P〈0．01）。血浆NT-proBNP浓度的正常参考值范围在60岁以下男女分别为160—470pmol／L和170—660pmol／L，60岁以上男女分别为180～760pmol／L和180～560pmol／L，总体为160—600pmol／L。结论在无器质性心脏病并且肾功能正常的成年人，血浆NT-proBNP浓度有性别差异，并在60岁以上男性随年龄增长而增加。

Objective To determine the reference value of plasma N-terminal pro-B-type natriuretic peptide （NT-proBNP） in subjects without heart diseases. Methods The plasma concentration of NT- proBNP was measured with ELISA method in 300 adults excluded heart disease through various examinations including electrocardiography, eehocardiography, X-ray and coronary artery angiography. The plasma NT-proBNP concentration was compared between age-groups 30-39, 40-49, 50-59, 60-69 and ≥70 years old, between male and female in the same age-group and between subjects with and without hypertension, diabetes and obesity. A multiple linear regression analysis was used to detect factors influencing NT-proBNP among age, sex, body mass index, blood pressure, heart rate, serum ereatinine, hypertension, diabetes mellitus, use of angiotensin-converting-enzyme inhibitors, Ca2 ~ -antagonist, and β-blocker. Results The plasma NT-preBNP concentration increased in proportion to aging in male subjects more than 60 years old （ P 〈 0. 05 ） , remained unchanged in males less than 60 years old and females （ P 〉 0. 05 ）. Plasma NT- proBNP concentration was significantly higher in female （ 170-660 pmol/L） than in male （ 160-470 pmol/L） in subjects less than 60 years old （P 〈 0.05 ） and significantly lower in female （180-560 pmol/L） than in male （180-760 pmol/L） in subjects more than 60 years old （P 〈0. 05 ）. Multiple linear regression analysis demonstrated that age was the only independent predictor for plasma NT-proBNP in these subjects （ P 〈 0. 01 ）. Conclusion The plasma concentration of NT-proBNP in subjects without heart diseases was different between male and female, and was increasing with age in male subjects more than 60 years old.