老年冠心病慢性心力衰竭患者血清NGAL与NT-proBNP的水平及临床意义  

Serum levels of neutrophil gelatinase associated lipocalin and NT-proB NP in elderly chronic heart failure patients with coronary artery disease and their clinical significance

作　　者：朱红[1] 马丽娜[1] 杨伟[1] 刘川[1] 冯明[1] 李耘[1] 钱玉英[1] 

机构地区：[1]首都医科大学宣武医院综合科,北京市100053

出　　处：《中华全科医学》2015年第4期523-525,555,共4页Chinese Journal of General Practice

基　　金：卫生部行业科研专项项目基金(201002011);北京市保健科研课题项目基金(京11-13号)

摘　　要：目的检测老年冠心病慢性心力衰竭(CHF)患者血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和血清N末端B型利钠肽原(NT-pro BNP)的水平变化,探讨血清NGAL水平与NT-pro BNP和肾功能指标的相关关系及其对老年冠心病CHF患者早期肾损害的诊断价值。方法测定54例老年冠心病CHF患者、30例老年冠心病心功能代偿患者和31例老年健康者血清NGAL和NT-pro BNP水平。采用Pearson相关分析得出血清NGAL水平与NT-pro BNP和肾功能指标的相关关系。应用受试者操作特征(ROC)曲线评价血清NGAL诊断早期肾损害的准确性。结果老年冠心病CHF患者血清NGAL和NT-pro BNP水平均明显高于心功能代偿患者和老年健康者,3组血清NGAL和NT-pro BNP水平两两比较差异均有统计学意义(P<0.01或P<0.05)。老年冠心病CHF患者血清NGAL水平与NT-pro BNP、Scr、BUN、Um ALB呈正相关(r值分别为0.809、0.553、0.439、0.441,P均<0.01);与估计肾小球滤过率(e GFR)呈负相关(r值为-0.563,P<0.01)。血清NGAL诊断肾功能不全的ROC曲线下面积为0.884,敏感度和特异度分别为93.5%和84.5%。结论血清NGAL是反映老年冠心病CHF患者心衰病情严重程度和诊断早期肾损害的较好指标。Objective To test the serum levels of neutrophil gelatinase associated lipoealin （NGAL） and N-terminal pro- B-type natriuretie peptide（NT-proBNP） in elderly chronic heart failure（CHF） patients with coronary artery disease,ex- plo]ye the correlation between renal function markers and serum NGAL and NT-proBNP, and investigate the diagnostic value of serum NGAL for early impairment of renal function. Methods The levels of serum NGAL and NT-proBNP were measured in 54 elderly CHF patients with coronary artery disease, 30 elderly patients with coronary artery disease but compensated heart function and 31 elderly healthy persons. The relationship between the renal function markers and the levels of serum NGAL and NT-proBNP was analyzed by Person correlation analysis. The accuracy of serum NGAL in diag- nosing renal insufficiency was evaluated by ROC curve. Results Serum NGAL and NT-proBNP levels in CHF group was higher than that of two other groups. The difference of serum NGAL and NT-proBNP level among three groups were signifi- cant（P 〈 0.01 or P 〈 0.05 ）. Pearson correlation analysis showed that serum NGAL level was positively correlated with NT-proBNP, Scr, BUN and UmALB （ r was 0.809,0. 553,0.439,0. 441, P 〈 0.01 respectively ） and was negatively corre- lated with EGFR（r was 0. 563 ,P 〈0.01 ）. The area under ROC curve of serum NGAL in diagnosing renal insufficiency was 0.884. The Sensitivity and specificity was 93.5% and 84.5% respectively. Conclusion Serum NGAL was a good marker for reflecting the severity of heart failure and diagnosing early impairment of renal function in elderly CHF patients with coronary artery disease.

关 键 词：中性粒细胞明胶酶相关脂质运载蛋白 N末端B型利钠肽原 心力衰竭 冠状动脉 肾功能 

分 类 号：R541.6[医药卫生—心血管疾病] R446.11[医药卫生—内科学]