BNP、CA125、IL-6、CRP检测在诊断慢性心力衰竭中的意义

Significance of Detection of BNP,CA125,IL-6 and CRP in the Diagnosis of Chronic Heart Failure

目的:探讨BNP、CA125、IL-6、CRP检测在诊断慢性心力衰竭(CHF)的意义。方法:选取2017年5月-2018年5月间本院收治的74例CHF患者(CHF组)与50例门诊体检健康者(健康对照组)进行回顾性研究,收集两组的血液标本以电化学发光免疫分析检测BNP、CA125、IL-6,免疫比浊法测定CRP,以Framingham的诊断标准作为"金标准",应用受试者工作曲线(receiver operating characteristic curves,ROC)观察比较BNP、CA125、IL-6和CRP分别与联合检测在诊断CHF中的效能。结果:CHF组患者的血清BNP、CA125、IL-6和CRP明显高于健康对照组(t=14.819,6.790,13.613,7.943,P=0.000,0.000,0.000,0.000)。ROC曲线显示,BNP联合IL-6诊断心血管疾病的曲线下面积(area under curve,AUC)最高(AUC=0.952,P=0.000),其次为BNP、IL-6、CA125和CRP(AUC=0.873、0.872、0.767、0.732,P=0.000、0.000、0.000、0.000),其中BNP联合IL-6的AUC高于BNP(Z=3.018,P=0.003)、IL-6(Z=2.570,P=0.010)、CA125(Z=4.170,P=0.000)和CRP(Z=4.277,P=0.000)。BNP联合IL-6的准确率高于CA125、IL-6和CRP(χ^(2)=11.468、4.026、14.427,P<0.05),灵敏度高于BNP、CA125、IL-6和CRP(χ^(2)=4.891、7.688、6.715、4.891;P<0.05)、特异性高于CA125,CRP(χ^(2)=3.843、10.187,P<0.05),阳性预测值高于CA125和CRP(χ^(2)=4.238、8.575;P<0.05),阴性预测值高于CA125、IL-6和CRP(χ^(2)=6.903、4.560、6.250;P<0.05)。结论:BNP、CA125、IL-6和CRP在慢性心衰中均明显升高,其中BNP联合IL-6检测在诊断CHF具有较高的诊断效能,有较大的临床应用意义。

Objective:To explore the significance of combined detection of BNP,CA125,IL-6 and CRP in the diagnosis of chronic heart failure(CHF).Method:A total of 74 CHF patients(group CHF)treated in our hospital from May 2017 to May 2018 and 50 healthy subjects(healthy control group)were studied,the blood samples of two groups were collected by electrochemiluminescence immunoassay to detect BNP,CA125,IL-6,and immunoturbidimetry to determine CRP.The diagnostic criteria of Framingham were used as standard.BNP,CA125,IL-6 and CRP with the joint detection in the diagnosis of CHF was compared with the receiver operating curve.Result:The serum levels of BNP,CA125,IL-6 and CRP in the CHF group were significantly higher than those in the healthy control group(t=14.819,6.790,13.613,7.943;P=0.000,0.000,0.000,0.0000).The area under the curve of BNP combined with IL-6(area under curve,AUC)was the highest(AUC=0.952,P=0.000),followed by BNP,IL-6,CA125 and CRP(AUC=0.873,0.872,0.767,0.732;P=0.000,0.000,0.000,0.000).The AUC of the BNP combined with IL-6 was higher than the IL-6(Z=2.570,P=0.010),CA125(Z=4.170,P=0.000),CRP(Z=4.277,P=0.000),and the best intercepting point.The accuracy of BNP combined with IL-6 was higher than that of CA125,IL-6 and CRP(χ^(2)=11.468,4.026,14.427,P<0.05),and the sensitivity was higher than that of BNP,CA125,IL-6 and CRP.The values are higher than CA125,IL-6 and CRP(χ^(2)=6.903,4.560,6.250,P<0.05).Conclusion:BNP,CA125,IL-6 and CRP are all significantly increased in chronic heart failure,and BNP combined IL-6 detection has a high diagnostic efficiency in the diagnosis of CHF and has great clinical significance.