NT-proBNP和cTnI联合检测在心衰患者诊治中的临床价值

Clinical value of NT-proBNP and cTnI detection in the diagnosis and treatment of congestive heart failure

目的探讨氨基末端B型钠尿肽原(NT-proBNP)和心肌肌钙蛋白I(cTnI)联合检测在心力衰竭(HF)患者诊治中的临床价值。方法选择心血管患者198例作为研究对象,其中HF患者95例作为HF组,非HF患者103例作为对照组,比较两组患者左心室射血分数(LVEF)及血清NT-proBNP、cTnI水平,并比较HF组不同心功能患者LVEF、血清NT-proBNP、cTnI水平,分析HF患者血清NT-proBNP、cTnI水平与LVEF的相关性。NT-proBNP、cTnI联合检测和单项检测对HF的诊断价值。结果 HF组LVEF及血清NT-proBNP、cTnI水平均高于对照组(P<0.05),HF组患者随着心功能分级的增加,LVEF明显下降,血清NT-proBNP、cTnI水平明显升高,差异有统计学意义(P<0.05),血清NT-proBNP、cTnI水平与LVEF呈负相关(r=-0.536、-0.328,P<0.05);proBNP、cTnI联合检测诊断HF的特异度、阳性预测值及准确率较单项检测明显提高,其中特异度、准确率与cTnI比较,差异有统计学意义(χ2=4.595、21.648,P=0.032、0.000)。结论血清NT-proBNP、cTnI水平检测对于HF的诊断及病情判断有重要的临床价值。

Objective To investigate the clinical value of NT‐proBNP and cTnI detection in the diagnosis and treatment of con‐gestiveheartfailure.Methods 198patientswithcardiovascularwereastheresearchobjects,95caseswithHFwereasHFgroup, 103 caseswithout HF were as control group ,compared left ventricular ejection fraction （LVEF） and serum NT‐proBNP ,cTnI levels of patients ,and compared LVEF ,serum NT‐proBNP ,cTnI levels of patients with different cardiac functions ,analysed the correla‐tion between serum NT‐proBNP ,cTnI levels and LVEF in patients with HF ,and analysed the diagnosic value of NT‐proBNP ,cTnI combined detection and single detection on HF .Results LVEF and serum NT‐proBNP ,cTnI levels of the HF group were higher than those of the control group（P＆lt;0 .05） ,LVEF of the HFgroup decreased significantly when cardiac function classification in‐creased ,serum NT‐proBNP ,cTnI levels increased significantly ,there were statistically significant differences in the indices between the three groups（P＆lt;0 .05） ,serum NT‐proBNP ,cTnI was inversely related to the level of LVEF （r= -0 .536 ,-0 .328 ,P＆lt;0 .05）;proBNP ,the specificity ,positive predictive value and accuracy in the diagnosis of HF byproBNP 、cTnI combined detection improved obviously than the single detection ,compared with cTnI the specificity ,accuracy rate ,there was difference significant（χ2 =4 .595 , 21 .648 ,P=0 .032 ,0 .000） .Conclusion It has important clinical value Serum NT‐proBNP ,cTnI levels detection for the diagnosis and judgment of HF .