摘要
目的探讨左室收缩功能不全(LVSD)的慢性心力衰竭(CHF)患者中N-末端B型脑钠肽前体(NT-proBNP)水平和同型半胱氨酸(HCY)水平的变化及其诊断价值。方法选取慢性心衰患者107例,其中左室射血分数(LVEF)≤50%的患者63例,LVEF>50%患者44例,同时选取健康体检人群61例。分别检测入选人群的NTproBNP和HCY血清浓度,比较三组人群中血清标志物的变化及其相关性,根据ROC曲线判断两者水平对LVSD慢性心衰患者的诊断价值。结果 LVSD患者中血清NT-proBNP和HCY水平均高于非LVSD患者和健康对照组,差异有统计学意义(P<0.05),且LVSD患者的NT-proBNP浓度与HCY呈正相关(r=0.267,P<0.05)。NT-proBNP和HCY对LVSD患者在ROC曲线下面积分别为0.82和0.72,根据ROC曲线确定cut-off值,NTproBNP为406.99 pg/mL时,诊断灵敏度93.3%,特异度57.6%;HCY水平为15.98μmol/L时,诊断灵敏度76.7%,特异度60.6%。结论 NT-proBNP和HCY水平均能作为LVSD慢性心衰患者的风险预测指标。
Objective To explore the changes of the levels of NT-proBNP and HCY for screening left ventricular sys- tolic dysfunction （LVSD） in patients with chronic heart failure （CHF）. Methods A total of 107 CHF patients were en- rolled, included 63 patients with left ventricular ejection fraction （LVEF） ~〈50%, 44 patients with LVEF〉50% and 61 persons in health control group. All cases were respectively measured the levels of NT-proBNP and HCY. Compared the correlation and values of serum biomarkers in various groups, analyzed the diagnostic value of biomarkers for LVSD according to ROC curve. Results The levels of NT-proBNP and HCY in LVSD group were higher than non- LVSD group and health group, and the difference show statistical significance （P 〈 0.05）, the correlation between the level of NT-proBNP and HCY was positive （r = 0.267, P 〈 0.05）. The area under ROC curve in patients with LVSD was NT-proBNP （0.82） and HCY （0.72）. Using a cut-off value of 406.99 pg/mL, NT-proBNP had a sensitivity of 93.3%, specificity of 57.6%; Used a cut-off value of 15.98 p^mol/L,HCY had a sensitivity of 76.7%, specificity of 60.6%. Conclusion The serum concentrations of NT-proBNP and HCY may be predictive factors and help to diagnose LVSD.
出处
《中国现代医生》
2013年第34期33-34,37,共3页
China Modern Doctor
