NT-proBNP定量检测在心力衰竭实验室诊断中的应用(英文)  

The Effectiveness of NT-proBNP in Diagnosing Heart Failure

作　　者：蔡蓓[1] 王兰兰[1] 刘瑾[1] 黄德嘉[2] 刘兴斌[2] 李立新[1] 唐江淘[1] 

机构地区：[1]四川大学华西医院实验医学科,成都610041 [2]四川大学华西医院心内科,成都610041

出　　处：《中国循证医学杂志》2005年第3期224-228,共5页Chinese Journal of Evidence-based Medicine

摘　　要：目的　评价血清N末端脑钠尿肽前体(NT proBNP)定量检测对不同程度心力衰竭患者的实验诊断价值,以及血清NT proBNP水平与心功能间的相关性。方法　采用电化学发光检测仪Elecsys2010定量检测,分析不同心功状态的心力衰竭患者血清NT proBNP水平。结果　①血清NT proBNP诊断心力衰竭的ROC曲线的曲线下面积 (AUC)为 0 880 (P<0 01 ),以 155pg/ml作为界值,其敏感性、特异性均为 81%,阳性似然比为4 25,而当NT proBNP水平 >350pg/ml时,阳性似然比可增至 14 32;②心衰患者血清NT proBNP水平明显增高,与心功能正常的心脏病患者比较有显著性差异 (P<0 05),血清NT proBNP含量随着心力衰竭程度加重呈指数增加,NT proBNP水平和心脏功能状态的秩相关性系数为 0 859 (P<0 01);③中国汉族人和欧洲人心功分级采用相同标准,但NT proBNP水平的表达程度不同。结论　血清NT proBNP定量检测是目前评价心力衰竭患者心功能状态较好的实验室指标,能够用于心力衰竭临床诊断。Objective To evaluate the diagnostic value of N terminal pro brain natriuretic peptide (NT proBNP) for heart failure (HF) and the relationship between NT proBNP and HF Methods Applying electrochemiluminescence immunoassay on Elecsys 2 010 quantitatively detects NT proBNP in HF patients with varing heart damage Results ① Using 155 pg/ml as the cutoff for diagnosis of HF, the sensitivity and specificity are both 80 %, positive likelihood ratio (PLR) is more than 4 0; when NT proBNP is more than 350 pg/ml, PLR is more than 14 ② NT proBNP significantly increases in HF patients,and has significant difference compared with disease control group, P<0 05 In dilated cardiomyopathy (DCMP) and acute myocardial infarction (AMI) NT proBNP is the highest, in coronary heart disease (CHD) and hypertension it’s the smallest With rising NYHA classes, NT proBNP increases exponentially The correlation between NT proBNP and heart function is good, rs=0 859 (P<0 01) Conclusions NT proBNP for diagnosing HF has a high sensitivity and specificity and can effectively evaluate heart function With worsening of heart damage, NT proBNP shows exponential or linear increase

关 键 词：N末端脑钠尿肽前体 心力衰竭 诊断性试验 

分 类 号：R541.610.4[医药卫生—心血管疾病]