血清N端B型钠尿肽原、心肌肌钙蛋白I及C反应蛋白联合检测在心力衰竭诊断中的临床价值

The clinical value about the combined detection of the serum N-terminal pro-B-type natriuretic peptide,Cardiac troponin I and C reactive protein in the diagnosis of heart failure

目的探讨血清N端B型钠尿肽原（NT-proBNP）、心肌肌钙蛋白I（cTnI）及C反应蛋白（CRP）联合检测在心力衰竭诊断中的临床价值。方法检测312例明确诊断为心力衰竭的不同病因、不同心功能分级[按美国纽约心脏病学会（NYHA）标准分为Ⅰ～Ⅳ级]患者以及120名健康对照者的血清NT—proBNP、cTnI及CRP水平。采用受试者工作特征（ROC）曲线评价各指标的敏感性和特异性，并分析3项指标联合检测的诊断价值。结果血清NT-proBNP、cTnI及CRP水平在心力衰竭不同心功能分级之间差异有统计学意义（P〈0．05），且心功能越差，其水平越高；NYHAI级的心力衰竭患者与对照组比较，NT-proBNP、CRP水平差异有统计学意义（P〈0．05），cTnI水平差异无统计学意义（P〉0．05）。心力衰竭患者3项指标联合检测对早期心力衰竭的敏感性为92．6％，明显高于单项检测（P〈O．01）。结论联合检测血清NT—proBNP、cTnI及CRP可为心力衰竭早期诊断提供参考依据，具有重要临床价值。

Objective To investigate the clinical value about the combined detection of the serum N terminal pro-B-type natriuretie peptide（NT-proBNP）,cardiac troponin I（cTnI） and C reactive protein（CRP） in the diagnosis of heart failure（HF）. Methods The serum levels of NT-proBNP,cTnI and CRP in 312 patients with different etiological factors and grades of HF[according to the cardiac function standard of New York Heart Association（NYHA） Ⅰ-Ⅳ] and 120 healthy controls were determined. The sensitivity and specificity of 3 parameters were evaluated by receiver operating characteristic （ROC）curve. Results The levels of NT-proBNP,cTnI and CRP in different grades of HF had statistical significant difference（P〈0.05）. In addition, the grade was worse, and its concentration was higher. The levels of NT-proBNP,cTnI and CRP showed significant difference between HF NYHA I grade patients and healthy people in control goup （P〈0.05）,and the level of cTnI had no significant difference（P〉0.05）. The sensitivity of combined detection was 92.6% in early HF diagnosis,which was significant higher than that of the individual detection（P〈0.01）. Conclusion The combined detection of the serum NT-proBNP,cTnI and CRP provides reference support to the diagnosis of early HF.