N末端B型利钠肽前体在慢性稳定性心力衰竭患者中的短期和长期生物学变异

Short-term and long-term biological variations of amino terminal proBNP in patients with chronic stable heart failure

目的 探讨N末端B型利钠肽前体(NT-proBNP)在慢性稳定性心力衰竭患者中的短期和长期生物学变异。方法 选取该院心血管内科2018年1-9月门诊的慢性稳定性心力衰竭患者29例,其中男15例、女14例,另选取同期体检健康者男女各10例。每个研究对象隔天同一时间采血一次,用于评估短期生物学变异;隔周同一时间采血一次,用于评估长期生物学变异。分别计算项目的个体内变异(CVI)、个体间变异(CVG)、个体指数(II)和参考变化值(RCV)。结果 健康人群NT-proBNP的总体短期CVI、CVG、RCV、II分别为32.55%、27.94%、92.21%、1.19,总体长期CVI、CVG、RCV、II分别为30.91%、25.52%、87.69%、1.24。慢性稳定性心衰患者总体短期CVI、CVG、RCV、II分别为12.96%、66.22%、37.89%、0.21,总体长期CVI、CVG、RCV、II分别为13.41%、65.51%、39.29%、0.22。所有人群的短期和长期、男性和女性比较差异无统计学意义(P>0.05)。结论 慢性稳定性心衰患者个体内生物学变异较体检健康者小,个体间的变异相对较大。临床在评估慢性稳定性心衰患者NT-proBNP两次检测结果是否有显著性病理改变时,使用参考值来判断的方法将不可取,更适合应用生物学变异计算的RCV来指导判断,推荐使用1.5倍RCV的值,即57.00%。

Objective To discuss the short-term and long-term biological variations of amino terminal proBNP(NT-proBNP)in patients with chronic stable heart failure.Methods 29 patients with chronic stable heart failure who came to the Department of Cardiovascular Medicine of the Third People′s Hospital of Mianyang from January to September 2018,including 15 males and 14 females were selected,and 10 healthy men and 10 healthy women who underwent the physical examination in the same period were also selected.Blood samples were collected in the same time once every other day for short-term biological variation,and were also collected once every other week for the long-term biological variation.Then,intra-individual variation(the within-subject coefficient of variations,CV I),individual variation between(between-subject coefficient of variations of the CV G),the individual index(index of individuality,II)changes and the reference value(the reference value,change the RCV)were calculated.Results The short-term CV I,CV G,RCV,II in healthy people were 32.55%,27.94%,92.21%and 1.19,and the long-term CV I,CV G,RCV,II were 30.91%,25.52%,87.69%and 1.24 respectively.The total short-term CV I,CV G,RCV,II in stability of chronic heart failure patients were 12.96%,66.22%,37.89%and 0.21,and the long-term CV I,CV G,RCV,II were 13.41%,65.51%,39.29%and 0.22,respectively.No significant differences were detected between the short-term and long-term,and male and female groups(P>0.05).Conclusion The CV I in stable heart failure is smaller than that in healthy individuals,but the CV G is larger.Therefore,it is inadvisable by using reference value to judge whether there are significant pathological changes in two results of NT-proBNP in patients with chronic stable heart failure,and the application of RCV will be a better choice,and 1.5 times of RCV is recommended,that is 57%.