心肌炎患者血清BNP及cTnⅠ的表达水平及相关性意义

Expression levels and correlation of serum BNP and cTnⅠ in patients with myocarditis

目的旨在研究心肌炎患者血清BNP及cTnⅠ的表达水平及相关性。方法选取本院2016年9月—2017年5月期间收治的确诊为心肌炎的患者100例,同时期非心脏病患者100例作为对照,回顾性分析所有研究对象入院时、症状控制后及出院前一天血清c Tnl、血浆BNP值,对患者血清c Tnl与血浆BNP值选择Pearson相关分析。结果心肌炎组患者在入院当天的c Tnl以及血浆BNP水平均显著高于非心脏病组患者,心肌炎组患者中,24例患者cTnⅠ在正常值以内,27例患者BNP水平未超过医学决定水平。cTnⅠ与BNP超过正常范围的患者中,入院时显著高于控制后(c Tnl:t=6.343,P<0.0001;BNP:t=14.94,P<0.0001),控制后显著高于出院前一天(c Tnl:t=8.532,P<0.0001;BNP:t=26.68,P<0.0001)。cTnⅠ与BNP水平均为阳性的患者,二项指标之间的相关性检验结果 r=0.546,所有心肌炎患者二项指标之间的相关性检验结果 r=0.647,相关性尚可。cTnⅠ与BNP联合检测诊断心肌炎时,cTnⅠ截断值取1397.6,BNP截断值取0.38时,灵敏度达到94.25%,特异度为90.37%,准确90.93%,显著高于单独检测cTnⅠ或BNP。结论 BNP与cTnⅠ具有一定的相关性,联合检测诊断心肌炎效果较为理想。

Objective： To study the expression level and correlation of serum BNP and cTnI in patients with myocarditis. Methods 100 cases of myocarditis diagnosed in our hospital from September 2016 to May-017 were selected, and 100 patients with non heart disease were selected as control group, The serum cTnl and plasma BNP values were analyzed retro- spectively on adnfission, symptom control and the daybefore discharge, and the correlation between serum cTnl and plasma BNP value was analyzed by Pearson. Results： Patients with myocarditis group on the adnfission day cTnl and plasma BNP levels were significantly higher than those in non heart disease group patients with myocarditis group, 24 cases of patients with cTnI in the normal range, 27 cases did not exceed the level of BNP in patients with medical decision level. CTnI and BNP above the normal range in patients on adnfission were significantly higher than control （ cTnl ： t = 6. 343, P 〈 0. 0001 ; BNP ： t = 14.94,P 〈 0.0001 ）, significantly higher than that of control after the day- before discharge （ cTnl ： t = 8. 532, P 〈 0.0001 ; BNP ：t = 26.68,P 〈 0.0001 ）. CTnI and BNP levels were positive patients, the correlation test results between the two indicators r = 0.546, the correlation test results of two indicators of all patients with myocarditis r = 0.647, correlation is acceptable. When cTnI and BNP were used to diagnose myocarditis, the cut-off value of cTnI was 1397.6, and the cut- off value of BNP was 0.38. The sensitivity was 94.25% , specificity- was 90.37% , accuracy was 90.93% , which was sig- nificantly higher than that of cTnI or BNP alone. Conclusion ： BNP has a certain correlation with cTnI, and the combined detection of myocarditis is ideal.