Nt-proBNP在老年充血性心力衰竭患者中的诊断价值  

The diagnosis Value of NT-proBNP in elderly patients with congestive heart failure

作　　者：张立建[1] 陈敏生[2] 刘世明[2] 侯维宁[1] 冯曙平[1] 钟世勤[1] 

机构地区：[1]广州医学院荔湾医院心内科,510170 [2]广州医学院第二附属医院心内科

出　　处：《中国临床实用医学》2009年第6期5-6,共2页China Clinical Practical Medicine

基　　金：广州市荔湾区科技局科技计划项目（项目编号：2007048-2）

摘　　要：目的探讨血清N末端B型钠尿肽（Nt-proBNP）在老年充血性心力衰竭（CHF）患者中的诊断价值。方法ELISA法检测80例老年CHF患者的血清Nt-proBNP水平，超声心动图测定LVEF≤45％，30例健康老年人作为正常对照组。结果CHF患者NYHAⅡ级组、Ⅲ级组、Ⅳ级组各组间Nt-proB-NP水平有统计学意义，且均高于对照组（分别为1218±853．4pmol／ml，2156±1543．5pmol／ml，3667±2469．0pmoL／ml对239±67．76pmol／m／，P〈0．001）。血浆Nt-proBNP水平与LVEF值呈负相关（r=-0．735，P〈0．01）。血清Nt-proBNP水平对CHF的诊断最适分界点为415pmol／L时，其敏感性为92．5％，特异性为93．3％，阳性预测值为97．4％，阴性预测值为82．4％。结论血清Nt-proBNP能有效诊断CHF，并能判断CHF的严重程度。Objective To determine the diagnosis value of the concentration Nt-proBNP in elderly pa- tients with congestive heart failure. Methods Enzyme-linked immunosorbent assay method was used to measure the levels of serum Nt-proBNP in 80 patients diagnosed of CHF, and 30 healthy subjects serving as control group. 80 patients were diagnosed as chronic heart failure （CHF） with left ventricular ejection （LVEF） ≤45%. Results The levels of serum Nt-proBNP were much higher in CHF patients than those in the control group（ P 〈 0. 001 ）. There were significant differences of plasma Nt-proBNP level among NYHA Ⅱ,Ⅲ ,and Ⅳ in CHF pa- tients（ The 1218 ±853.4 pmol/ml,2156 ± 1543.5 pmol/ml,3667 ± 2469. 0 pmol/ml vs 239 ± 67. 76 pmol/ml, P 〈0. 01）. The plasma level of Nt-proBNP had significant negative correlation with LVEF （r =-0. 735,P 〈 0. 01 ）. The cutoff value of Nt-proBNP for diagnosis of CHF was 415 pmol/L. The sensitivity, specificity, positive predictive values and negative predictive values was 92. 5% ,93.3% ,97.4% and 82. 4% ,respectively. Conclusion Plasma Nt-proBNP level may be a valuable laboratory plasma marker for diagnosis of congestive heart fail-ure.

关 键 词：NT-PROBNP 老年人 充血性心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]