摘要
目的通过测定不同病因所致充血性心力衰竭(CHF)患者血清脑利钠肽(BNP)和生长激素(GH)的水平变化,对比观察两者在CHF中的诊断价值及其灵敏度和特异度。方法将受试对象分为非心衰组30例和心衰组72例。心衰组中冠心病31例,高血压病12例,风湿性心脏病16例,扩张型心肌病13例。其中NYHA心功能分级Ⅱ级组22例,Ⅲ级组20例,Ⅳ级组30例。用酶联免疫法测定血清BNP和GH的浓度,同时行心脏彩色多普勒超声测定左室舒张末内径(LVED)和左室射血分数(LVEF)。结果心衰组BNP水平较非心衰组显著升高(P<0.001);GH水平较非心衰组升高(P<0.05)。在不同病因组间,BNP和GH均无显著性差异(P>0.05)。BNP和GH诊断心衰的ROC曲线下面积为BNP>GH,灵敏度和特异度BNP均优于GH(P<0.05)。BNP和GH均与心功能级别呈正相关,P值均为<0.001。结论⑴BNP和GH均有助于CHF的诊断;⑵BNP诊断CHF的灵敏度和特异度均优于GH。⑶二者单用对于心衰诊断的灵敏度高于联合应用,可用于筛选;BNP和GH联合应用可提高特异度,降低假阳性率,减少筛选成本。
Objective To evaluate the diagnostic value of growth hormone （GH） and brain natriuretic peptide （BNP）, and contrast their sensitivity and specificity in patients with congestive heart failure. Methods The blood samples were obtained from 72 patients with congestive heart failure （CHF） and 30 patients without congestive heart failure. We measured their serum level of GH and BNP by ELISA, At the same time all patients received colorful doppler uhrasonocardiogram to determine left ventricular end-dilate diameter （LVED）and left ventricular ejection fraction （LVEF）. Results BNP levels in CHF group were markedly higher than those in non-CHF group （P〈0.001）;GH levels in CHF group were higher than those in non-CHF group（p〈0.05）. BNP and GH had negative correlations to EF, and had positive correlations to LVED（p〈0.001 ）and different classification of heart function （P〈0.001）.The areas under the receiver operating characteristic （ROC）curve shows BNP〉GH. Conclusion GH and BNP levels can help to establish the diagnosis of different classification of heart function; The sensitivity and specificity of BNP are better than that of GH. The sensitivity of GH or BNP alone are better than the combination of GH and BNP, the specificity of the combination of GH and BNP are better than GH or BNP alone.
出处
《实用心脑肺血管病杂志》
2007年第6期409-413,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
生长激素
脑利钠肽
心力衰竭
Growth hormone Brain Natriuretic Peptide Heart failure
