摘要
目的测定心衰及左、右心衰患者血中β型钠尿肽(BNP)含量与心功能分级等指标之间的关系,探讨BNP对心衰与左、右心衰及心功能的评价作用。方法用化学发光免疫分析法测定血清BNP浓度。以美国纽约心脏病协会(NYHA)分级方案,结合临床医生依据病史、症状、体症和超声心动图等客观检查作出的综合判断为金标准。结果心衰组BNP浓度(481.2±186.7pg/mL)显著高于正常对照组(97.47±21.33pg/mL)(P<0.01)。同级心功能状况下,左心衰组BNP浓度显著高于右心衰(P<0.01)心衰血及左、右心衰组BNP浓度与NYHA分级的相关分析显示,前者有高度正相关(r=0.88,P<0.01),后两者显著正相关(r=0.912,P<0.01)和中度正相关(r=0.796,P<0.05)。BNP诊断无症状及有症状心衰的切分点(Cut off值)为118.2pg/mL和253.4pg/mL;前者的灵敏度和特异性为82.0%和98.4%,后者为93.6%和100%;前者诊断心衰的阳性预测值和阴性预测值为98.0%和67.0%,后者为100%和78.0%。结论BNP可准确评价心功能,对心衰及左、右心衰的诊断、心功能分级具有较高灵敏度和准确性,可以作为临床诊断无症状和有症状心衰及左、右心衰和心功能分级的有效指标。
[Objective] To determine the correlation between serum β-type Brain Natriuretic Peptide （BNP） levels in patients with heart failure or left or fight heart failure and grades of their cardiac function or other indexes, and investigate the value of BNP in diagnosing heart failure or left or fight heart failure and assessing grades of their cardiac function. [Methods] Serum BNP levels were assayed by Chemiluminescence Immunoassay （CLIA）. Judgment on grade of cardiac function was made in llne with gradation method developed by New York Heart Disease Association （NYHA）, basing on comprehensive survey by clinical physician on history, symptoms, signs and wtrasonic cardiogram and results of objective examinations of the patients being tested or belong to the reference group. [Results] Serum BNP levels of the test group（ 481.2＋186.7 pg/ml） were significantly higher than that of the reference group（97.47＋21.33 pg/ml）（P 〈0.01）. The group with left heart failure had serum BNP levels higher than that with fight heart failure while patients of the same cardiac function grade were compared. The cardiac function gradation results based on NYHA＇ s method were highly positively correlated with serum BNP level of heart failure group （r =0.88, P 〈0.01） significantly positively correlated with that of left heart failure group （r =0.912, P 〈0.01） and moderately positively correlated with that of night failure group （r =0.796, P 〈0.05）. The Receiver Operating Characteristic （ROC） curves showed the cut off value for BNP-mediated asymptomatic heart failure diagnosis was 118.2 pg/ml and that of symptom was 253.4 pg/ml, while sensitivity and specificity of the former were 82.0% and 98.4% respectively and those of the latter were 93.6% and 100% respectively. The positive and negative predicative value for the diagnosis of the former were 98% and 67% respective and those of the latter were 100% and 78% re- spectively. [Conclusions] Serum BNP level can be effectively used to assess cardi
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2007年第6期701-703,共3页
China Journal of Modern Medicine
关键词
钠尿肽
心功能分级
充血性心衰
评价
β-type natriuretic peptide （BNP）
left or right heart failure
grades of cardiac function
