无器质性心脏病者血浆N末端B型利钠肽原浓度及其影响因素  

Plasma N-terminal pro-B-type natriuretic peptide reference value in subjects without heart diseases

作　　者：韦丙奇[1] 杨跃进[2] 张健[1] 张春玲[3] 徐波[4] 高润霖[2] 

机构地区：[1]北京协和医学院中国医学科学院心血管病研究所阜外心血管病医院心力衰竭监护病房,100037 [2]北京协和医学院中国医学科学院冠心病诊治中心,100037 [3]北京协和医学院中国医学科学院临床检验中心,100037 [4]北京协和医学院中国医学科学院介入治疗中心,100037

出　　处：《中华心血管病杂志》2009年第9期804-808,共5页Chinese Journal of Cardiology

摘　　要：目的探讨成年人血浆N末端B型利钠肽原（NT—proBNP）的正常参考值范围及影响因素。方法选择常规临床检查和冠状动脉造影正常的成年人300例，用酶联免疫吸附法检测血浆NT-proBNP浓度。以每10岁为一个年龄组，比较各年龄组间和相同年龄组的男女间血浆NT—proBNP浓度的差异，并分别比较有与无高血压病、糖尿病及超重者的血浆NT—proBNP浓度。用多元逐步回归分析方法，分析血浆NT—proBNP浓度的影响因素。并计算血浆NT-proBNP浓度的正常参考值。结果在正常成年人，血浆NT—proBNP浓度在男性60岁以上者随年龄升高而升高（P〈0．05），而在男性60岁以下者和女性则不随年龄变化而变化（均P〉0．05）。男女间比较，血浆NT—proBNP浓度在60岁以下女性高于男性（P〈0．05），而60岁以上则男性高于女性（P〈0．05）。有与无高血压病、糖尿病及超重者间分别比较血浆NT-proBNP浓度均无统计学差异（均P〉0．05）。多元逐步回归分析表明，年龄是血浆NT—proBNP浓度的独立预测因素（P〈0．01）。血浆NT-proBNP浓度的正常参考值范围在60岁以下男女分别为160—470pmol／L和170—660pmol／L，60岁以上男女分别为180～760pmol／L和180～560pmol／L，总体为160—600pmol／L。结论在无器质性心脏病并且肾功能正常的成年人，血浆NT-proBNP浓度有性别差异，并在60岁以上男性随年龄增长而增加。Objective To determine the reference value of plasma N-terminal pro-B-type natriuretic peptide （NT-proBNP） in subjects without heart diseases. Methods The plasma concentration of NT- proBNP was measured with ELISA method in 300 adults excluded heart disease through various examinations including electrocardiography, eehocardiography, X-ray and coronary artery angiography. The plasma NT-proBNP concentration was compared between age-groups 30-39, 40-49, 50-59, 60-69 and ≥70 years old, between male and female in the same age-group and between subjects with and without hypertension, diabetes and obesity. A multiple linear regression analysis was used to detect factors influencing NT-proBNP among age, sex, body mass index, blood pressure, heart rate, serum ereatinine, hypertension, diabetes mellitus, use of angiotensin-converting-enzyme inhibitors, Ca2 ~ -antagonist, and β-blocker. Results The plasma NT-preBNP concentration increased in proportion to aging in male subjects more than 60 years old （ P 〈 0. 05 ） , remained unchanged in males less than 60 years old and females （ P 〉 0. 05 ）. Plasma NT- proBNP concentration was significantly higher in female （ 170-660 pmol/L） than in male （ 160-470 pmol/L） in subjects less than 60 years old （P 〈 0.05 ） and significantly lower in female （180-560 pmol/L） than in male （180-760 pmol/L） in subjects more than 60 years old （P 〈0. 05 ）. Multiple linear regression analysis demonstrated that age was the only independent predictor for plasma NT-proBNP in these subjects （ P 〈 0. 01 ）. Conclusion The plasma concentration of NT-proBNP in subjects without heart diseases was different between male and female, and was increasing with age in male subjects more than 60 years old.

关 键 词：利钠肽 脑 参考值 

分 类 号：R686[医药卫生—骨科学]