摘要
目的：分析年龄对氨基末端脑钠肽前体（NT‐proBNP）诊断急性心力衰竭（AHF）的影响，探讨AHF诊断中不同年龄段NT‐proBNP最佳截断值。方法收集临床疑诊AHF并于入院24h内行NT‐proBNP检测的患者457例，其中确诊AHF者194例。将AHF和非AHF患者按年龄分为3个组（＜50岁、＞50～70岁、＞70岁），分析NT‐ProBNP与AHF的相关性，评价NT‐ProBNP在各组中诊断AHF的价值并进行最佳截断值的比较。结果各年龄组中AHF患者的NT‐proBNP中位数水平均较非AHF患者明显升高（P＜0．01）。应用NT‐proBNP诊断≤50岁、＞50～70岁和＞70岁3个组中AHF患者的工作特征曲线下面积（AUC）分别为0．95、0．91、0．88，最佳诊断截点分别为1100pg／mL、1800pg／mL和3000pg／mL，诊断特异性分别为88％、76％和73％。总体而言，按年龄分组的NT‐proBNP截断值诊断的特异性较不按年龄分组的高。结论NT‐proBNP在不同年龄患者中均具有较好的诊断AHF的价值。根据年龄分组，不同年龄段选用不同NT‐proBNP截断值，可提高诊断的特异性。
Objective To analyze the influence of age on the diagnosis of acute heart failure （AHF） with amino terminal brain natriuretic peptide （NT‐proBNP） ,and to explore the best cut‐off value of NT‐proBNP in the diagnosis of AHF .Methods Totally 457 inpatients suspected with AHF obtained a blood NT‐proBNP measurement within 24 hours when in charged ,including 194 patients with AHF .Patients were divided into three groups according to their age ：≤50 years ,〉50-70 years and 〉70 years . The relationship between NT‐proBNPand AHF was analyzed .The diagnostic value of NT‐proBNP was evaluated for AHF in differ‐ent age groups .Results The median NT‐proBNP levels of AHF in all age groups were significantly higher than those without （P〈0 .01） .AUC of NT‐proBNP for AHF in ≤50 years ,〉50-70 years and 〉70 years groups were 0 .95 ,0 .91 ,0 .88 ,the best diagnos‐tic cut‐off points were 1 100 ,1 800 ,3 000 pg/mL ,respectively .The diagnostic specificity was 88% ,76% and 73% ,respectively .O‐verall ,the specificity of NT‐proBNP cut‐off values for age group was higher than non‐age groups .Conclusion NT‐proBNP has a good value in the diagnosis of AHF in patients with different ages .According to the age group ,the different NT‐proBNP cut‐off values can be used to improve the specificity of diagnosis .
出处
《重庆医学》
CAS
北大核心
2016年第36期5085-5087,共3页
Chongqing medicine
