NT-proBNP在心力衰竭诊断中的价值

Clinical application and evaluation of N-terminal pro-Brain natriuretic peptide quantitative detection in heart failure laboratory diagnosis

目的探讨N-末端脑利钠肽原(NT-proBNP)定量检测在心力衰竭诊断和病情评估中的应用价值。方法按Fram-inghan诊断标准和排除标准纳入该院心内科心力衰竭患者139例为心力衰竭组,按美国纽约心脏病学会(NYHA)分级;对照组60例。评价两组心功能和临床情况,并采用固相免疫法测定血浆NT-proBNP浓度。结果血浆NT-proBNP的诊断性实验受试者工作特征曲线的曲线下面积为0.860(P<0.01),cutoff值为309.4pg/mL,其敏感性为76.0%,特异性为90.0%,阳性似然比为7.6。心力衰竭患者血浆NT-proBNP水平明显升高,与对照组比较其差异有统计学意义(P<0.01);血浆NT-proBNP水平随着心力衰竭程度加重而增加(P<0.01)。结论在患者心力衰竭的进展中其血浆中NT-proBNP水平与心力衰竭程度密切相关,测定患者血浆NT-proBNP水平是监测心力衰竭程度的有效手段之一。

Objective To evaluate the diagnostic value of N-terminal pro-Brain natriuretic peptide（NT-proBNP）quantitative detection for heart failure,and analyze the relationship between plasma NT-proBNP and heart function.Methods 139 patients with heant failare and to health controls were studied.The levels of NT-proBNP were determinated by immunochromatographic assay.Results Receiver operator characteristic curve（ROC） showed that area under curve（AUC） was 0.860（P0.01）;and 309.4 pg/mL was the best cutoff for diagnosing heart failure with 76.0% sensitivity and 90.0% specificity,and positive likelihood ratio（PLR） was 7.60.NT-proBNP significantly increases in heart failure patients,and had significance comparing healthy controls（P0.01）.NT-proBNP level was elevated with increment of NYHA categorization（P0.01）.Conclusion Plasma levels of NT-proBNP are closely related to the severity of heart failure and could serve as a biochemical marker for assessing the caridiac function.