血浆BNP、CPN、ET-1对肺源性心脏病诊断价值的临床研究  

A Clinical Study on Diagnostic Values of Plasma BNP,CPN and ET-1 for Pulmonary Heart Disease

作　　者：蒋娅 张欣 程亚玲 JIANG Ya;ZHANG Xin;CHENG Yaling(Department of Cardiovascular Medicine, West China Guang’an Hospital, Sichuan University, Guang’an 638000, China)

机构地区：[1]四川大学华西广安医院心血管内科,四川广安638000

出　　处：《标记免疫分析与临床》2021年第4期604-607,共4页Labeled Immunoassays and Clinical Medicine

基　　金：四川省科技厅计划项目(编号:Q17035)。

摘　　要：目的探讨血浆脑钠肽(brain natriuretic peptide,BNP)、和肽素(copeptin,CPN)及血清内皮素-1(endothelin 1,ET-1)对于肺源性心脏病(肺心病)的诊断价值。方法回顾性分析2016年9月至2019年2月我院收治的92例肺心病患者,其中肺心病代偿组67例,肺心病失代偿组25例;另选同期来我院体检的健康人员40例为对照组。比较三组受试者基本资料,检测血浆BNP、CPN、ET-1水平;Logistic回归分析法分析肺心病的危险因素,并以受试者工作特征(receiver operating characteristic,ROC)曲线评估相应的诊断价值。结果肺心病组患者的血浆BNP、CPN及ET-1水平均显著高于对照组(P<0.05),且肺心病失代偿组患者的BNP、CPN水平均高于肺心病代偿组(P<0.05);Logistic回归分析显示,BNP(OR=2.016,P=0.019)增加、CPN(OR=2.010,P=0.029)增加及ET-1(OR=1.831,P=0.046)增加均是影响肺心病发生的独立危险因素(P<0.05);BNP诊断肺心病的AUC为0.946,显著高于CPN和ET-1诊断的0.836和0.768(P<0.05),且与三者联合诊断(AUC=0.966)差异无统计学意义(P>0.05)。结论BNP、CPN、ET-1水平均可作为诊断肺心病的重要指标,以BNP的诊断价值最高,值得临床推广。Objective To explore diagnostic values of plasma brain natriuretic peptide(BNP),copeptin(CPN)and serum endothelin-1(ET-1)for pulmonary heart disease(PHD).Methods A retrospective analysis was performed on 92 PHD patients who were admitted to the hospital from September,2016 to February,2019,including 67 cases in the PHD compensation group and 25 cases in the PHD decompensation group.40 healthy people who underwent physical examination in the hospital during the same period were enrolled in the control group.The basic data were compared among the three groups,and the levels of plasma BNP,CPN and ET-1 were detected in all subjects.Logistic regression analysis was performed to analyze potential risk factors of PHD.The corresponding diagnostic values of these markers were evaluated by ROC curves.Results The levels of plasma BNP,CPN and ET-1 in the PHD group were significantly higher than those in the control group(P<0.05).There were significant differences in BNP and CPN levels between the PHD decompensation group and PHD compensation group(P<0.05).Logistic regression analysis showed BNP increase(OR=2.016,P=0.019),CPN increase(OR=2.010,P=0.029)and ET-1 increase(OR=1.831,P=0.046)were all independent risk factors influencing occurrence of PHD(P<0.05).AUC of BNP for the diagnosis of PHD was 0.946,significantly higher than those of CPN and ET-1(0.836 and 0.768,respectively)(P<0.05).There was no significant difference in AUC between the combination of those two for the diagnosis(AUC=0.966)and that of BNP(P>0.05).Conclusion The levels of BNP,CPN and ET-1 can be applied as important indexes for the diagnosis of PHD,in which the diagnostic value of BNP is the highest.

关 键 词：血浆脑钠肽 肽素 血清内皮素-1 肺源性心脏病 

分 类 号：R541.5[医药卫生—心血管疾病]