血清NT-proBNP和Cys-C水平联合检测在心力衰竭诊断与分型中的应用

Application of Combined Detection of Serum NT-proBNP and Cys-C Levels in Diagnosis and Typing of Heart Failure

目的探讨血清氨基末端B型脑钠肽(NT-proBNP)和胱抑素-C(Cys-C)水平联合检测在心力衰竭诊断与分型中的应用。方法选取心力衰竭诊断明确的75例患者为试验组,选取同期查体健康者75例为对照组。用双向侧流免疫法检测血清NT-proBNP水平;用乳胶免疫比浊法检测Cys-C水平,通过统计学分析观察其差异性和相关性。结果试验组血清NT-proBNP为816±338pg/ml,Cys-C为1.28±0.34mg/L,对照组血清NT-proBNP为38.2±19.9pg/ml,Cys-C为0.72±0.17mg/L,试验组患者血清联合检测水平均高于对照组患者水平,差异均有统计学意义(t=33.6,12.6,均P<0.05);试验组按NYHA心功能分级与对照组比较,差异均有统计学意义(F=43.2,26.6,均P<0.05);血清NT-proBNP和Cys-C联合检测明显提高对心力衰竭诊断的敏感度和特异度,差异均有统计学意义(r=0.58,均P<0.05)。结论血清NT-proBNP和Cys-C水平联合检测是心力衰竭诊断与分型的重要检测指标,为实验室心力衰竭诊断比较理想的应用组合。

Objective To investigate the application of combined detection of serum N terminal B-type natriuretic peptide （NT proBNP） and cystatin -C （Cys- C） in the diagnosis and classification of heart failure. Methods 75 patients with heart failure were selected as the experimental group and 75 healthy subjects were selected as the control group. Serum NT proB NP level was detected by bidirectional flow immunoassay, and Cys C level was detected by latex immunoturbidimetry. The difference and correlation were observed by statistical analysis. Results The levels of NT proBNP and Cys C in the experi mental group and the control group were 816±338 pg/ml,1.28±0.34 mg/L;38.2±19.9 pg/ml,0.72±0.17 mg/L respec tively. Compared with the control group, the difference of functional classification was statistically significant （F= 43.2, 26.6, all P〈0.05）, and the combined detection of NT proBNP and Cys C significantly increased the sensitivity and specifici ty of the diagnosis of heart failure （r=0.58,all P〈0.05）. Conclusion The combined detection of serum NT proBNP and Cys C levels is an important index for the diagnosis and typing of heart failure,and is an ideal combination for laboratory di agnosis of heart failure.