摘要
目的:评估血尿素氮/肌酐比(blood urea nitrogen/creatinine ratio,BUN/Cr)、心肌肌钙蛋白Ⅰ(cardiac troponinⅠ,cTnⅠ)和N末端B型利钠肽原(NT-proBNP)在诊断急性左心衰竭患者的严重程度方面的有效性。方法:选取连云港市第二人民医院检验科2023年1月—2024年2月接收的122份急性左心衰竭患者的血清样本作为研究样本,根据急性生理学及慢性健康状况评分Ⅱ(APACHEⅡ)将患者分为轻症组(APACHEⅡ评分≤20分,45例)、重症组(APACHEⅡ评分21~30分,42例)及极重症组(APACHEⅡ评分≥31分,35例)。比较三组患者的血清BUN/Cr、cTnⅠ及NT-proBNP水平,采用Spearman分析评估血清BUN/Cr、cTnⅠ及NT-proBNP水平与急性左心衰竭患者严重程度的相关性,并构建受试者操作特征(ROC)曲线分析血清BUN/Cr、cTnⅠ及NT-proBNP水平对极重症急性左心衰竭患者的诊断价值。结果:极重症组的血清BUN/Cr、cTnⅠ及NT-proBNP水平均高于重症组、轻症组,且重症组均高于轻症组,差异均有统计学意义(P<0.05);相关性分析结果显示,血清BUN/Cr、cTnⅠ及NT-proBNP水平与急性左心衰竭患者的严重程度呈正相关(P<0.05);ROC曲线分析结果显示,血清BUN/Cr、cTnⅠ及NT-proBNP联合检测的敏感度、特异度分别为94.3%、90.8%,ROC曲线下面积(AUC)为0.969,优于单独检测。结论:在急性左心衰竭患者中,血清BUN/Cr、cTnⅠ及NT-proBNP的水平与疾病严重程度相关,联合检测可以有效诊断急性左心衰竭患者的疾病严重程度,具有较高的敏感度和特异度。
Objective:To evaluate the effectiveness of the blood urea nitrogen/creatinine ratio(BUN/Cr),cardiac troponin I(cTnI),and N-terminal pro-brain natriuretic peptide(NT-proBNP)in diagnosis the severity of acute left heart failure.Method:A total of 122 serum samples from acute left heart failure patients admitted to the Laboratory Department of Lianyungang Second People's Hospital from January 2023 to February 2024 were selected.According to the acute physiology and chronic health evaluationⅡ(APACHEⅡ)scoring system,patients were divided into mild group(APACHEⅡscore≤20 scores,45 cases),severe group(APACHEⅡscore 21-30 scores,42 cases),and very severe group(APACHEⅡscore≥31 scores,35 cases).The serum levels of BUN/Cr,cTnI,and NT-proBNP were compared among the three groups.Spearman's correlation analysis was performed to evaluate the correlation between serum BUN/Cr,cTnI,and NT-proBNP levels and the severity of acute left heart failure.Receiver operating characteristic(ROC)curve analysis was used to assess the diagnosis value of serum BUN/Cr,cTnI,and NT-proBNP levels for very severe acute left heart failure.Result:The serum levels of BUN/Cr,cTnI,and NTproBNP in the very severe group were higher than those in the severe group and mild group,and the severe group had higher levels of BUN/Cr,cTnI,NT-proBNP than those of the mild group,with statistically significant differences(P<0.05).Correlation analysis showed that serum BUN/Cr,cTnI,and NT-proBNP levels were positively correlated with the severity of acute left heart failure(P<0.05).ROC curve analysis revealed that the combined detection of serum BUN/Cr,cTnI,and NT-proBNP had a sensitivity of 94.3%,a specificity of 90.8%,and an area under the ROC curve(AUC)of 0.969,which was superior to individual testing.Conclusion:In acute left heart failure patients,the levels of serum BUN/Cr,cTnI,and NT-proBNP are associated with disease severity.Combined detection can effectively predict the severity of acute left heart failure with high sensitivity and specificity.
作者
李娜
曹若雪
姚丽
LI Na;CAO Ruoxue;YAO Li(Department of Laboratory,Lianyungang Second People's Hospital,Lianyungang 222006,China;不详)
出处
《中国医学创新》
CAS
2025年第1期153-157,共5页
Medical Innovation of China
关键词
尿素氮
肌酐
心肌肌钙蛋白Ⅰ
N末端B型利钠肽原
急性左心衰竭
Urea nitrogen
Creatinine
Cardiac troponin I
N-terminal pro-brain natriuretic peptide
Acute left heart failure