老年慢性心力衰竭患者血浆氨基末端脑钠肽前体和肌红蛋白的变化及其辅助诊断效能

Changes of Plasma N-terminal pro-Brain Natriuretic Peptide and Myoglobin in Elderly Patients with Chronic Heart Failure and Their Diagnostic Efficacy

目的探讨老年慢性心力衰竭患者血浆氨基末端脑钠肽前体(NT-proBNP)、肌红蛋白(Mb)水平变化及其辅助诊断效能。方法选取2017年2月—2019年4月收治的老年慢性心力衰竭患者124例作为研究组,以及同期体检的身体健康老年人60例作为对照组。比较研究组入院时及对照组体检时血浆NT-proBNP、Mb水平差异。根据纽约心脏协会(NYHA)心功能分级将研究组分为相应亚组,比较不同NYHA心功能分级患者入院时血浆NT-proBNP、Mb水平差异;分析NT-proBNP联合Mb检测对于老年慢性心力衰竭的辅助诊断效能。结果研究组入院时血浆NT-proBNP、Mb水平均明显高于对照组,差异有统计学意义(P<0.01);随着NYHA心功能分级的加重,患者血浆NT-proBNP、Mb水平均逐渐升高,差异有统计学意义(P<0.05,P<0.01);NT-proBNP联合Mb检测诊断老年慢性心力衰竭的灵敏度和特异度略低于NT-proBNP或Mb单一检测,但差异均无统计学意义(P>0.05)。结论老年慢性心力衰竭患者血浆NT-proBNP、Mb水平明显升高,且随着病情程度的加重逐渐升高;NT-proBNP联合Mb检测有助于老年慢性心力衰竭的早期诊断。

Objective To investigate the changes of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP)and myoglobin(Mb)levels in the elderly patients with chronic heart failure(CHF)and their diagnostic efficacy.Methods A total of 124 elderly patients with CHF admitted from February 2017 to April 2019 were selected as the research group,and 60 healthy elderly persons who underwent physical examinations during the same period were selected as the control group.The differences of plasma NT-proBNP and Mb levels between the research group at admission and the control group at physical examination were compared.According to the New York Heart Association(NYHA)cardiac function classification,the research group was divided into corresponding subgroups to compare the difference of plasma NT-proBNP and Mb levels between patients with different NYHA cardiac function classification at admission.The auxiliary diagnostic efficacy of NT-proBNP combined with Mb detection for elderly patients with CHF was analyzed.Results The plasma NT-proBNP and Mb levels of the research group at admission were significantly higher than those of the control group(P<0.01).With the aggravation of NYHA cardiac function classification,the plasma NT-proBNP and Mb levels of patients were gradually increased(P<0.05,P<0.01).The sensitivity and specificity of NT-proBNP combined with Mb detection in the diagnosis of elderly CHF was slightly lower than that of NT-proBNP or Mb single detection,but the differences were not statistically significant(P>0.05).Conclusion Plasma NT-proBNP and Mb levels in elderly patients with CHF were increased significantly,and gradually increased with the severity of the disease.NT-proBNP combined with Mb detection was helpful for the early diagnosis of elderly patients with CHF.