中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2010年
4期
328-332
,共5页
冷文修%何昆仑%范利%梁致如
冷文脩%何昆崙%範利%樑緻如
랭문수%하곤륜%범리%량치여
心力衰竭,舒张性%利钠肽%脑%肽碎片%每搏输出量
心力衰竭,舒張性%利鈉肽%腦%肽碎片%每搏輸齣量
심력쇠갈,서장성%리납태%뇌%태쇄편%매박수출량
Heart failure,diastolic%Natriuretic peptide,brain%Peptide fragments%Stroke volume
目的 研究慢性心力衰竭患者血浆BNP及NT-proBNP浓度的变化,评价BNP及NT-proBNP对鉴别舒张性心力衰竭的作用.方法 对2004-2006年在解放军总医院临床诊断为舒张性心力衰竭129例患者和收缩性心力衰竭109例患者进行血浆BNP和NT-proBNP浓度测定,通过与对照组(77名)的比较,分析血浆BNP和NT-proBNP升高的相关因素,并用ROC曲线评价BNP和NT-proBNP对鉴别舒张性心力衰竭的作用.结果 和对照组(血浆BNP和NT-proBNP浓度中位数分别为58.51 ng/L和69.80 ng/L)比较,慢性心力衰竭患者血浆BNP和NT-proBNP浓度明显升高,其中舒张性心力衰竭和收缩性心力衰竭组患者血浆BNP浓度中位数分别为254.16 ng/L和923.08 ng/L,NT-proBNP浓度中位数分别为899 ng/L和3 695 ng/L,血浆BNP和NT-proBNP升高的程度与NYHA心功能分级显著相关(β值分别为0.201和0.323,P值均<0.001).BNP和NT-proBNP诊断慢性心力衰竭的曲线下面积分别为0.906(95%可信区间:0.865～0.946)和0.956(95%可信区间:0.932～0.980),BNP鉴别舒张性心力衰竭和收缩性心力衰竭的曲线下面积为0.781(95%可信区间:0.710～0.852),NT-proBNP鉴别舒张性心力衰竭和收缩性心力衰竭的曲线下面积为0.757(95%可信区间:0.686～0.828).结论 慢性心力衰竭患者的血浆BNP和NT-proBNP水平均明显升高,升高的程度和NYHA心功能分级相关,两者是诊断慢性心力衰竭的良好指标,但对鉴别舒张性心力衰竭的作用不大.
目的 研究慢性心力衰竭患者血漿BNP及NT-proBNP濃度的變化,評價BNP及NT-proBNP對鑒彆舒張性心力衰竭的作用.方法 對2004-2006年在解放軍總醫院臨床診斷為舒張性心力衰竭129例患者和收縮性心力衰竭109例患者進行血漿BNP和NT-proBNP濃度測定,通過與對照組(77名)的比較,分析血漿BNP和NT-proBNP升高的相關因素,併用ROC麯線評價BNP和NT-proBNP對鑒彆舒張性心力衰竭的作用.結果 和對照組(血漿BNP和NT-proBNP濃度中位數分彆為58.51 ng/L和69.80 ng/L)比較,慢性心力衰竭患者血漿BNP和NT-proBNP濃度明顯升高,其中舒張性心力衰竭和收縮性心力衰竭組患者血漿BNP濃度中位數分彆為254.16 ng/L和923.08 ng/L,NT-proBNP濃度中位數分彆為899 ng/L和3 695 ng/L,血漿BNP和NT-proBNP升高的程度與NYHA心功能分級顯著相關(β值分彆為0.201和0.323,P值均<0.001).BNP和NT-proBNP診斷慢性心力衰竭的麯線下麵積分彆為0.906(95%可信區間:0.865～0.946)和0.956(95%可信區間:0.932～0.980),BNP鑒彆舒張性心力衰竭和收縮性心力衰竭的麯線下麵積為0.781(95%可信區間:0.710～0.852),NT-proBNP鑒彆舒張性心力衰竭和收縮性心力衰竭的麯線下麵積為0.757(95%可信區間:0.686～0.828).結論 慢性心力衰竭患者的血漿BNP和NT-proBNP水平均明顯升高,升高的程度和NYHA心功能分級相關,兩者是診斷慢性心力衰竭的良好指標,但對鑒彆舒張性心力衰竭的作用不大.
목적 연구만성심력쇠갈환자혈장BNP급NT-proBNP농도적변화,평개BNP급NT-proBNP대감별서장성심력쇠갈적작용.방법 대2004-2006년재해방군총의원림상진단위서장성심력쇠갈129례환자화수축성심력쇠갈109례환자진행혈장BNP화NT-proBNP농도측정,통과여대조조(77명)적비교,분석혈장BNP화NT-proBNP승고적상관인소,병용ROC곡선평개BNP화NT-proBNP대감별서장성심력쇠갈적작용.결과 화대조조(혈장BNP화NT-proBNP농도중위수분별위58.51 ng/L화69.80 ng/L)비교,만성심력쇠갈환자혈장BNP화NT-proBNP농도명현승고,기중서장성심력쇠갈화수축성심력쇠갈조환자혈장BNP농도중위수분별위254.16 ng/L화923.08 ng/L,NT-proBNP농도중위수분별위899 ng/L화3 695 ng/L,혈장BNP화NT-proBNP승고적정도여NYHA심공능분급현저상관(β치분별위0.201화0.323,P치균<0.001).BNP화NT-proBNP진단만성심력쇠갈적곡선하면적분별위0.906(95%가신구간:0.865～0.946)화0.956(95%가신구간:0.932～0.980),BNP감별서장성심력쇠갈화수축성심력쇠갈적곡선하면적위0.781(95%가신구간:0.710～0.852),NT-proBNP감별서장성심력쇠갈화수축성심력쇠갈적곡선하면적위0.757(95%가신구간:0.686～0.828).결론 만성심력쇠갈환자적혈장BNP화NT-proBNP수평균명현승고,승고적정도화NYHA심공능분급상관,량자시진단만성심력쇠갈적량호지표,단대감별서장성심력쇠갈적작용불대.
Objective To investigate the plasma levels of BNP and NT-proBNP in patients with chronic heart failure(CHF),and to evaluate the capabilities of them to discriminate diastolic heart failure(DHF)from systolic heart failure(SHF).Methods One hundred and twenty nine patients with DHF and109 patients with SHF were subjected to plasma BNP and NT-proBNP determination in Beijing PLA general hospital from the year of 2004 to 2006.The factors influencing the levels of BNP and NT-proBNP were analyzed through the comparison with results from 77 age and gender-matched healthy volunteers.ROC was used to evaluate the mles of BNP and NT-proBNP in the diagnosis of Diastolic heart failure.Results Compared with the controls.plasma BNP and NT-proBNP concentrations were upregulated significantly in DHF and SHF patients,with the median of 254.16 ng/L and 899 ng/L in DHF and 923.08 ng/L and 3 695 ng/L in SHF respectively.The increase extent of BNP and NT-proBNP was exclusively related to NYHA classification of heart function(β=0.201 and 0.323 respectively,P<0.001).BNP and NT-proBNP showed AUCs of 0.906(95% CI: 0.865-0.946)and 0.956(95% CI:0.932-0.980)respectively for diagnosis of CHF.BNP and NT-proBNP showed AUCs of 0.781(95% CI: 0.710-0.815)and 0.757(95% CI: 0.686-0.828)respectively for diagnosis of DHF and SHF.Conclusions BNP and NT-proBNP are upregnlated significantly in CHF patients and associated with the NYHA classification significantly and exclusively.BNP and NT-proBNP can be used to identify CHF rather than DHF.
