脑钠肽与脑钠肽前体对心力衰竭的诊断价值

Value of Brain Natriuretic Peptide and Pro-Brain Natriuretic Peptide in the Diagnosis of Cardiac Failure

目的研究分析脑钠肽(BNP)与脑钠肽前体(NT-pro BNP)对心力衰竭的诊断价值。方法选取本院2014年1月至2015年1月收治的心力衰竭患者150例,根据患者的心功能进行分组,分为Ⅱ组、Ⅲ组、Ⅳ组各50例。选取同时期健康体检心功能正常者为对照组,分别测定BNP与NT-pro BNP血浆浓度并进行比较。结果对照组心率、血压、血浆BNP与NTpro BNP水平明显低于其他三组,而左心室射血分数明显高于其他三组,差异均有统计学意义(均P<0.05)。心力衰竭患者中,心功能分级越高,BNP与NT-pro BNP血浆浓度越高,差异具有统计学意义(P<0.05)。随着年龄的增加,BNP的灵敏度逐渐下降,特异性相对稳定,而pro-BNP特异性逐渐降低,灵敏度无明显变化。结论 BNP与NT-pro BNP在心力衰竭诊断中具有重要意义,浓度越高患者心衰程度越高,且NT-pro BNP灵敏度更高,值得广泛应用。

Objective To analyze the value of brain natriuretic peptide （BNP） and pro-brain natriuretic peptide （NT-proBNP） in the diagnosis of cardiac failure. Methods 150 patients with cardiac failure admitted to our hospital from January 2014 to January 2015 were selected and divided into groupⅡ, groupⅢand groupⅣaccording patients＆#39; heart function degree, with 50 cases in each group. 50 cases of healthy subjects with normal heart function at the same period were selected as control group. The plasma concentrations of BNP and NT-proBNP were detected. Results The heart rate, blood pressure, and plasma concentrations of BNP and NT-proBNP of control group were significantly lower than those of the other 3 groups, while the left ventricular ejection fraction was significantly higher than that of the other 3 groups （all P 〈0.05）. For patients with cardiac failure, the higher the cardiac function classification, the higher the BNP and NT-proBNP plasma concentrations. With the increase of age, BNP had decreasing sensitivity and relatively stable specificity, while pro-BNP had gradually decreasing specificity and no significant changes in sensitivity. Conclusions BNP and NT-proBNP have great significance in the diagnosis of heart failure, the higher the degree of concentration, the higher the heart failure degree, and NT-proBNP has higher sensitivity.