NT-proBNP、CTn-I的联合检测在急诊呼吸困难患者诊治中的应用  

Diagnosis value of combined detection of N-terminal Pro-brain natriuretic peptide and cTn-I in patients with dyspnea in emergency department

作　　者：朱小林[1] 王成刚[1] 朱月清[1] 

机构地区：[1]义乌市中心医院检验科,浙江义乌322000

出　　处：《中国卫生检验杂志》2014年第11期1593-1595,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的研究联合检测氨基末端B型钠尿肽原(NT-proBNP)和心肌肌钙蛋白-I(cTn-I)在急诊呼吸困难患者诊治中的作用。方法利用酶联免疫荧光法对送诊到本院急诊室的719例呼吸困难患者进行血浆NT-proBNP和cTn-I水平检测,比较心源性呼吸困难患者(主要为CHF患者)和非心源性呼吸困难患者血浆中NT-proBNP和cTn-I值的差别,并对检测结果进行统计分析。结果 285例心力衰竭患者(HF)血浆NT-proBNP中位数为4 218 ng/L(930 ng/L^13 225 ng/L),cTn-I中位数(四分位数)为8.12μg/L(1.02μg/L^18.22μg/L),明显高于434例非HF患者[NTproBNP中位数为123 ng/L(28 ng/L^509 ng/L)](P<0.001),[cTn-I中位数为0.68μg/L(0.01μg/L^2.29μg/L)(P<0.001)],差异具有统计学意义;血浆NT-proBNP诊断CHF的最佳阈值为900 ng/L,其敏感性为91%、特异性为86%,ROC曲线下面积为0.845,YOUDEN指数为0.77;联合检测NT-proBNP和cTn-I敏感性为99%,特异性为92%,优于单项检测。结论对于急诊室送诊的呼吸困难患者,及时进行NT-proBNP和cTn-I水平的联合检测在诊断和治疗中十分有价值。Objective To investigate the diagnosis value of combined detection of the N-terminal Pro-brain natriuretic peptide（NT-proBNP） and cTn-I in patients with dyspnea in emergency department.Methods Enzyme-linked immunosorbent fluorescence method was adopted to determine the levels of NT-proBNP and cTn-I in 719 dyspnea patients of emergency department,and the levels of NT-proBNP and cTn-I were compared between the patients with cardiac dyspnea（mainly CHF patients） and non-cardiac dyspnea,then the detection results were conducted statistical analysis.Results The medians of NT-proBNP and cTn-I in 285 CHF patients were 4 218 ng /L（930 ng /L - 13 225 ng /L） and 8.12 μg /L（1.02 μg /L -24.22 μg /L）,obviously higher than those in 434 patients with other cardiovascular diseases were 123 ng /L（28 ng /L -509 ng /L） and 0.68 μg /L（0.01 μg /L - 2.29 μg /L） respectively（both P〈0.001）.The best threshold value of serum NT-proBNP level in CHF diagnosis was 900 ng /L,and the sensitivity,specificity,the area under ROC curve and YOUDEN index were 91%,86%,0.845 and 0.77 respectively.While the sensitivity and specificity of combined detection of NT-proBNP and cTn-I were 99% and 92%,better than the single detection.Conclusion Combined detection of NT-proBNP and cTn-I is a valuble diagnostic marker for patients with dyspnea in emergency department.

关 键 词：氨基末端B型钠尿肽原 心肌肌钙蛋白I 充血性心力衰竭 呼吸困难 

分 类 号：R446.6[医药卫生—诊断学]