NT-pro-BNP在心脏性晕厥患者中诊断和预测价值的临床研究

Clinical study on the diagnostic and predictive value of NT-pro-BNP in patients with cardiac syncope

目的评估心肌标志物N末端脑钠肽原(NT-pro-BNP)在心脏性晕厥患者中的诊断和预测价值。方法检测101例因晕厥入住北京友谊医院急诊科的患者(中位年龄65岁,男性占58.00%)的NT-pro-BNP水平,通过ROC曲线分析NT-pro-BNP对心脏性晕厥的诊断价值,并且分析其与晕厥的心脏病因及6个月的预后之间的相关性(比值比:OR;95%置信区间:CI)。结果由于心律失常或器质性心脏病患者引起晕厥的患者的NT-pro-BNP值均显着高于非心脏性晕厥患者。以156 pg/ml作为截断值,其在诊断心脏性晕厥中的敏感度为88.90%,特异度为50.90%。在对患者随访期间产生的不良事件进行分析显示NT-pro-BNP>156 pg/ml显著预测了不良事件的发生(OR 2.63,95%CI:1.02~6.78,P<0.05)。结论 NT-pro-BNP是一个强力并且独立的诊断和预测心脏性晕厥的标记物,将其添加到传统的包含病史及化验检查的标准中可以提高其鉴别能力。

Objective To evaluate the diagnostic and predictive value of N - terminal brain natriuretic peptide （NT - pro - BNP） in pa-tients with cardiac syncope. Methods NT - pro - BNP had been evaluated in 101 hospitalized patients （with median age 65 years and 58. 00% males） from the Emergency Department of this hospital due to syncope. The ROC curve analysis had been used to assess the diagnostic value of NT -pro - BNP for cardiac syncope. The relationship among value of NT - pro - BNP, the etiology of syncope and 6 - month prognosis had also been analyzed [ Odds ratio （OR） , 95% confidence interval： （Cl） ] . Results The value of NT - pro - BNP was significantly higher in patients with cardiac syncope than that with non - cardiac syncope. When 156 pg/ml was used as the cutoff value, the sensitivity and specificity were 88. 90% and 50. 90% respectively in diagnosis of cardiac syncope. The analysis of adverse events of patient in follow - up period showed that NT - pro - BNP 〉 156 pg/ml could significantly predict the occurrence of adverse events （OR 2. 63, 95% Cl： 1.02 ？6. 7 8 ,P 〈0.05） . Conclusion NT - pro - BNP is a potent and independent marker for the diagnosis and prediction of cardiogenic syncope, and it can be enhanced by adding it in tradi-tional criteria including medical history and laboratory tests.