松弛素和B型钠尿肽联合对充血性心力衰竭的诊断价值

The diagnostic value of combination of plasma relaxin and BNP in patients with congestive heart failure

目的:评估血浆松弛素水平对充血性心力衰竭(congestive heart failure,CHF)的诊断价值,并探讨松弛素和B型钠尿肽(B-type natriuretic peptide,BNP)联合对提高CHF诊断的临床价值。方法:纳入2015-01-2017-06在我院就诊的CHF患者96例(CHF组),并以无CHF的患者48例作为对照组。收集两组患者的各项实验室检查与超声心动图结果,并通过ELISA法检测患者的血浆松弛素水平,通过受试者工作特征曲线(receiver operating characteristic,ROC)判断血浆松弛素和BNP对CHF的诊断价值和诊断阈值。结果:CHF组血浆松弛素水平[68.2(43.0,112.4)pg/ml∶33.5(23.2,64.8)pg/ml,P<0.001]和BNP水平[289.0(91.8,849.2)pg/ml∶48.3(15.5,98.0)pg/ml,P<0.001]均显著高于对照组。血浆松弛素对CHF的诊断价值高于BNP,ROC曲线下面积分别为0.894和0.736,诊断阈值分别为39.76pg/ml和99.0pg/ml。联合血浆松弛素>39.76pg/ml且BNP>99.0pg/ml对CHF的诊断价值显著高于单用松弛素或单用BNP。结论:血浆松弛素和BNP联合能够提高对CHF的诊断价值,具有较好的临床应用前景。

Objective：To evaluate the diagnostic value of plasma relaxin in patients with congestive heart failure（CHF）and to evaluate the clinical value of combination of relaxin and B-type natriuretic peptide（BNP）.Method：A total of 96 patients with CHF admitted to our hospital from January 2015 to June 2017 were enrolled as CHF group,and 96 patients without CHF were enrolled as control group.The data of laboratory and echocardiographic results were collected and the level of plasma relaxin was measured by ELISA.The diagnotic value and diagnostic threshold of plasma relaxin and BNP were determined by receiver operating characteristic（ROC）.Result：The levels of plasma relaxin[68.2（43.0,112.4）pg/ml vs 33.5（23.2,64.8）pg/ml,P〈0.001]and BNP [289.0（91.8,849.2）pg/ml vs 48.3（15.5,98.0）pg/ml,P〈0.001]in CHF group were significantly higher than those in control group.The diagnostic value of plasma relaxin was higher than BNP,with the area under ROC curve were0.894 and 0.736,respectively,and the diagnostic thresholds were 〉39.76 pg/ml and 〉99.0 pg/ml,respectively.The diagnostic value of combination of plasma relaxin39.76 pg/ml and BNP99.0 pg/ml was significantly higher than either relaxin or BNP alone.Conclusion：Combination of plasma relaxin and BNP can improve the diagnostic value of CHF,and has a good clinical application prospect.