脑钠素和N-心钠素在无症状性心力衰竭中的诊断价值  

Diagnostic value of brain natriuretic peptide and Nterminal atrial natriuretic peptide in silent heart failure

作　　者：黄彦生[1] 魏经汉[1] 魏太星[1] 王锦荣[1] 赵洛沙[1] 邱春光[1] 董建增[1] 

机构地区：[1]河南医科大学第一附属医院心内科

出　　处：《中国危重病急救医学》1998年第1期39-42,共4页Chinese Critical Care Medicine

摘　　要：目的：评价脑钠素（ＢＮＰ）和Ｎ心钠素（ＮＡＮＰ）对无症状性心力衰竭的诊断价值。方法：通过放射性核素门控心血池显像，筛选无症状性心力衰竭患者３２例，心力衰竭患者３２例，并选取心功能正常的健康人２０例作为对照组；采用放射免疫法测定３组血浆ＢＮＰ和ＮＡＮＰ水平。结果：无症状性心力衰竭组血浆ＢＮＰ〔（９８．７２±４８．９６）ｎｇ／Ｌ〕和ＮＡＮＰ〔（１３８２．２５±５４９．５１）ｎｇ／Ｌ〕水平显著高于对照组〔分别为（３９．０６±１８．２０）ｎｇ／Ｌ和（４２２．０６±２５５．３８）ｎｇ／Ｌ，Ｐ＜０．０５和Ｐ＜０．００１〕，却显著低于心力衰竭组〔分别为（１５０．９０±８３．６６）ｎｇ／Ｌ和（４０２０．４３±２０９０．９５）ｎｇ／Ｌ，Ｐ＜０．０５和Ｐ＜０．００１〕；血浆ＢＮＰ＞７５．００ｎｇ／Ｌ（对照组的ｘ＋１．９６ｓ）时，诊断无症状性心力衰竭，敏感性为９１％，特异性为９４％；血浆ＮＡＮＰ＞９２３．００ｎｇ／Ｌ（对照组的ｘ＋１．９６ｓ），诊断无症状性心力衰竭，敏感性为７５％，特异性为９４％。结论：ＢＮＰ和ＮＡＮＰ可用来诊断无症状性心力衰竭；且以ＢＮＰ＞７５．００ｎｇ／Ｌ同时ＮＡＮＰ＞９２３．００ｎｇ／Ｌ作为诊断无症状性心力?Objective:To evaluate diagnostic value of plasma brain natriuretic peptide(BNP) and Nterminal atrial natriuretic peptide (NANP) in patients with silent heart failure (SHF).Methods:Radionuclide ventriculography was performed to select patients with SHF (n=32) and patients with heart failure (n=32).Twenty healthy volunteers with normal ventricular function served as control group.The plasma BNP and NANP concentrations of 3 groups were tested by radioimmunoassay.Results:The plasma BNP and NANP concentrations of SHF were significantly higher than that of controls(P<005,P<0001 respectively),but remarkably lower than that of heart failure group(P<005,P<0001 respectively).A plasma BNP concentration exceeding 7500 ng/L (mean of the controls +196 s) had a sensitivity of 91% and a specificity of 94% for detection of patients with SHF.A plasma NANP concentration exceeding 92300 ng/L (mean of the controls+196 s) had a sensitivity of 75% and a specificity of 94% for detection of patients with SHF.Conclusions:These findings indicate that SHF can be identified by plasma BNP and NANP.The plasma BNP (≥75 ng/L) and the plasma NANP(≥923 ng/L) are good markers for SHF.

关 键 词：心力衰竭 无症状性 N-心钠素 脑钠素 诊断 

分 类 号：R541.604[医药卫生—心血管疾病]