风湿性心脏病相关临床检验指标的研究

Research of relevant laboratory indexes of rheumatic heart disease

目的探讨相关检验指标与风湿性心脏病(RHD)的关系及临床意义。方法收集236例风湿热引起的心脏损害患者的病案信息,分为3组:RHD组、单纯风湿热组、健康对照组。分别测定这3组患者的肌红蛋白(Mb)、肌钙蛋白I(cTnI)、N-端脑钠肽前体(NT-proBNP)等相关指标。结果在RHD组和单纯风湿热组之间,Mb、cTnI、肌酸激酶同工酶(CK-MB)、NT-proBNP水平差异有统计学意义(P<0.05);在RHD组和健康对照组之间,红细胞沉降率(ESR)、风湿因子(RF)、C反应蛋白(CRP)、cTnI、Mb、CK-MB、肌酸激酶(CK)、NT-proBNP水平差异均有统计学意义(P<0.05)。以136.17pg/mL作为临界值,NT-proBNP对RHD的诊断敏感度为95.48%,特异度为90.15%,阳性预测值为86.7%,阴性预测值为97.86%。结论 RHD患者血中cTnI、Mb、CK-MB与单纯风湿热组及健康对照组相比明显升高,NT-proBNP浓度的测定是早期诊断RHD的敏感指标。

Objective To investigate the relationship between the related indexes with rheumatic heart disease（RHD）and its clinical significance.Methods The medical records information in 236 patients with rheumatic fever caused cardiac were collected and divided into the RHD group,simple rheumatic fever group and normal healthy control group.The levels of related indiexe such as Mb and cTnI were detected in the three groups.Results The Mb,cTnI and CK-MB and NT-proBNP had statistical differences between the RHD group and simple rheumatic fever groups（P〈0.05）;the levels of ESR,RF,CRP,cTnI,Mb,CK-MB,CK and NT-proBNP had statistically significant differences between the RHD group and healthy control group（P〈0.05）;With the NT-proBNP level of 136.17pg/mL as the critical value,the sensitivity,specificity,positive predictive value and negative predictive value of NT-proBNP for diagnosing RHD were 95.48%,90.15%,86.7% and 97.86% respectively.Conclusion The levels of blood cTnI,Mb and CK-MB in the patients with RHD are significantly higher than those in the normal controls,so detecting the serum NTproBNP concentration is a sensitive indicator for early diagnosis of RHD.