老年慢性心力衰竭患者脑钠肽和N末端脑钠肽前体水平检测及意义

Determination and meaning of NBP and NT-proBNP in elderly patients with chronic heart failure

目的检测老年慢性心力衰竭(CHF)患者血清脑钠肽(BNP)和N末端脑钠肽前体(NT-proBNP)水平,比较其在老年慢性心力衰竭中的诊断价值。方法选取已确诊的老年慢性心衰患者116例,老年健康体检者50例,NBP用全自动荧光磁微粒酶免分析仪检测,NT-proBNP用电化学发光免疫分析仪检测,比较血清NBP和NT-proBNP浓度与NYHA心功能分级关系,并作ROC曲线分析。结果与对照组比较,CHF组血清BNP和NT-proBNP水平均显著升高(P<0.01),血清NT-proBNP水平高于BNP,并与BNP显著相关(r=0.763,P<0.01);BNPROC曲线下面积为0.726(95%CI:0.612～0.769),cutoff值为150ng/L为时,敏感性为76.0%,特异性为61.6%,NT-proBNPROC曲线下面积为0.769(95%CI:0.661～0.842),cutoff值为250 ng/L时,灵敏度为81.96%,特异性为74.16%。结论血清NBP和NT-proBNP浓度检测对老年CHF均有一定诊断价值,血清NT-proBNP比BNP相对较为敏感。

Objective To determinate the levels of serum BNP （ Brain natriuretic peptide, BNP） and NT - proBNP （ N - terminal pro - brain natriuretic peptide, NT - proBNP） in elderly patients with CHF （chronic heart failure, CHF） , and to investigate their diagnostic values. Methods Totally 116 elderly patients with CHF and 50 elderly health control were selected. Serum BNP and NT - proBNP were measured with automatic enzyme immunoassay system and chemiluminescence immunoassay respectively. Comparing the relationship of BNP and NT - proNBP with NYHA heart classic function, and making ROC assay. Results Compared with the health control, the levels of serum BNP and NT - proBNP in elderly patients with CHF increased （ P 〈 0.01 ） significantly. Elevated NT - proBNP significantly correlated with BNP （r = 0. 763, P 〈 0.01 ）. The AUC of BNP was 0. 726 （95 % C I：0.661 -0. 842）. When cutoff was 150ng/L, the sensitivity and specificity of BNP were 76.0% and 6l. 6% respectively. The AUC of NT -proNBP was 0. 769 （95% CI：0. 661 -0. 842）. When cutoff was 250rig/L, the sensitivity and specificity of NT - proNBP were 81.96% and 74. 16% respectively. Conclusions Both serum BNP and NT- proNBP are diagnostic value for elderly patients with CHF. NT - proNBP is a biochemical index more sensitive than BNP for diagnosis of elderly patients CHF.