心房利钠肽前体中间片段在呼吸困难的老年患者中对射血分数保留的心力衰竭的诊断价值  

Diagnostic value of midregional proatrial natriuretic peptide for heart failure with preserved ejection fraction in elderly patients with dyspnea

作　　者：陈晓丽[1] 罗智[1] 高茂龙[3] 田爱炬 王泽宇 翁绳凤[2] 贾丁 冯世兴 杨祖芳 CHEN Xiaoli;LUO Zhi;GAO Maolong;TIAN Aiju;WONG Sheng-feng;WANG Zeyu;FENG Shixing;JIA Ding;YANG Zufang(Department of Cardiology,Beijing Geriatric Hospital,Beijing 100095,China)

机构地区：[1]北京老年医院心内科,100095 [2]北京老年医院检验科,100095 [3]北京老年医院老年病临床与康复研究所

出　　处：《心肺血管病杂志》2021年第6期544-547,共4页Journal of Cardiovascular and Pulmonary Diseases

基　　金：北京老年医院老年医学科研专项(2020bjlnyy-重-2)。

摘　　要：目的:探讨心房利钠肽前体中间片段(MRpro-ANP)在呼吸困难的老年患者中,对射血分数保留的心力衰竭(HFpEF)的诊断价值。方法:选取2018年05月至2020年10月,在我院诊治的以呼吸困难为临床表现的老年患者,分析所有的临床资料,按照入排标准,纳入临床确诊为HFpEF和非心力衰竭两组,分析BNP与MR-proANP对HFpEF的诊断价值,分别做ROC曲线,并比较曲线下面积(AUC),分析两者对HFpEF的诊断价值。结果:共纳入患者352例分析,平均年龄(73.3±7.4)岁,分为HFpEF组142例和非心力衰竭组210例,年龄、高血压和2型糖尿病是发生HFpEF的主要因素,HFpEF组按照纽约心脏病协会(NYHA),分为Ⅱ-Ⅳ级,各级血清BNP与MR-proANP均高于非心力衰竭组,且两者升高的程度均与NYHA分级程度相关;ROC曲线分析显示,MR-proANP对HFpEF的诊断ROC曲线下面积AUC高于BNP,两者联合检测诊断价值高于单独检测(P<0.05)。结论:MR-proANP在呼吸困难的老年患者中对HFpEF的诊断价值较BNP有优势,两者联合诊断价值优于单独诊断。Objective:To investigate the diagnostic value of midregional proatrial natriuretic peptide(mrpro-ANP)for heart failure with preserved ejection fraction(HFpEF)in elderly patients with dyspnea.Meth-ods:From May 2018 to October 2020,the elderly patients with dyspnea in our hospital were selected to analyze.According to the inclusion criteria,the patients with heart failure(HFpEF)and non heart failure were included,the BNP and mrpro-ANP were analyzed.The ROC curve and area under the curve(AUC)were compared to analyze the diagnostic value of BNP and Mr-proANP in HFpEF.Results:A total of 352 patients with an average age of(73.3±7.4)years were included in the study.They were divided into HFpEF group(142 cases)and non heart failure group(210 cases).Age,hypertension and type 2 diabetes were the main factors for HFpEF.The levels of BNP and Mr-proANP were higher than those in non-heart failure group,and the degree of increase of both was related to the degree of NYHA classification;ROC curve analysis showed that the AUC under ROC curve of Mr-proANP in the diagnosis of HFpEF was higher than that of BNP,and the diagnostic value of combined detection of both was higher than that of single detection(P<0.05).Conclusions:MR-proANP is superior to BNP in the diagnosis of HFpEF in elderly patients with dyspnea,and the combined diag-nosis is better than single diagnosis.

关 键 词：心房利钠肽前体中间片段 射血分数保留的心力衰竭 呼吸困难 老年 

分 类 号：R54[医药卫生—心血管疾病]