健康社区人群N末端B型利钠肽原的分布特征及其影响因素

Plasma amino-terminal pro-brain natriuretic peptide level and affecting factors in a community-based healthy Chinese population

目的 探讨北京地区健康人群N末端B型利钠肽原（NT-proBNP）的血浆水平及其影响因素.方法 2012年3至7月入选北京社区健康人群1 034例,其中男性486例,女性548例.留取血浆标本,采用荧光免疫分析法进行NT-proBNP检测.采用经验法估计NT-proBNP的正常参考值范围,分析影响健康人NT-proBNP血浆水平的因素.结果 年龄和性别是影响健康人NT-proBNP水平的重要因素,年龄＜45岁、45 ～ 54岁、55 ～ 64岁、65 ～ 74岁时,男性NT-proBNP水平均明显低于女性（P值分别为0.005、0.001、0.001、0.011）,年龄≥75岁时NT-proBNP水平性别间差异无统计学意义（P =0.504）.无论男性、女性,NT-proBNP水平均随年龄增长而升高.体质指数也是影响NT-proBNP水平的独立因素（P＜0.001）,而在一定肾功能范围内,估测肾小球滤过率并非NT-proBNP的独立影响因素.NT-proBNP参考值范围：＜55岁以下人群男性＜133 ng/L,女性＜289 ng/L;55～ 74岁人群男性＜ 185 ng/L,女性＜333 ng/L;≥75岁人群男性＜465 ng/L,女性＜378 ng/L.结论 影响北京地区健康人血浆NT-proBNP水平的主要因素为年龄、性别和体质指数,根据这些因素探讨人群NT-proBNP参考值范围具有重要价值.

Objective To investigate the plasma level of amino-terminal pro-brain natriuretic peptide （NT-proBNP） and related influencing factors in a community-based healthy population in Beijing area.Methods We measured plasma NT-proBNP level by fluoroimmunoassay between March 2012 and July 2012 from 1 034 healthy subjects （including 486 men and 548 women）.Empiric method was used to determine the reference value and influencing factors were analyzed.Results Age and gender are important factors affecting the level of NT-proBNP in healthy subjects.NT-proBNP plasma level is significantly higher in women than in men within each age strata below 75 years old,i.e.〈45,45-54,55-64 and 65-74 years old （P =0.005,0.001,0.001,0.011 respectively）,but NT-proBNP plasma level is similar between male and female older than 75 years （P =0.504）.NT-proBNP level also increases with age irrespective of gender.Body mass index （BMI） is another independent influencing factor of NT-proBNP （P 〈0.001）,while estimated glomerular filtration rate is not influencing factor.The reference range of NT-proBNP is 〈133 ng/L for men and 〈289 ng/L for women aged 〈55 years old,〈 185 ng/L for men and 〈333 ng/L for women aged between 55 and 64 years old,and 〈465 ng/L for men and 〈378 ng/L for women aged ≥75 years old.Conclusion The major influencing factors of NT-proBNP level in the healthy population are age,gender and BMI.It essential to establish normal reference range of NT-proBNP according to these factors for Chinese population.