血浆心房利钠肽原中间片段在心力衰竭合并心房颤动患者中的诊断价值  

The diagnosis value of plasma mid-regional pro-atrial natriuretic peptide in patients with heart failure complicated with atrial fibrillation

作　　者：罗飞 李树仁[2] 郝潇[2] 白玉豪 苑智慧 赵文静 李健超 LUO Fei;LI Shuren;HAO Xiao;BAI Yuhao;YUAN Zhihui;ZHAO Wenjing;LI Jianchao(Graduate School,North China University of Science and Technology,Tangshan,Hebei,063210,China;Cardiovascualr Department,Hebei People′s Hospital;Graduate School,Hebei Medical University;Graduate School,Hebei North University)

机构地区：[1]华北理工大学研究生院,河北唐山063210 [2]河北省人民医院心血管内科 [3]河北医科大学研究生院 [4]北方学院研究生院

出　　处：《临床心血管病杂志》2022年第9期736-742,共7页Journal of Clinical Cardiology

摘　　要：目的:分析血浆心房利钠肽原中间片段(MR-proANP)在心力衰竭(HF)合并心房颤动(AF)患者中的诊断价值。方法:选取河北省人民医院心血管内科住院的慢性HF患者207例,并纳入无HF及AF诊断但患有冠心病、糖尿病等57例为对照组。按照院前有无AF将HF分为窦性心律HF(HF-SR)组和HF合并AF(HF-AF)组,比较这3组患者基本资料差异。ROC曲线评价MR-proANP对HF-AF的诊断价值。结果:(1)MR-proANP在3组患者中的差异有统计学意义(P<0.05)。(2)左房内径(LAD)、MR-proANP在HF-AF组与HF-SR组中的差异有统计学意义(P<0.017)。(3)ROC分析显示,在HF-AF患者中,以对照组作为对照,MR-proANP诊断HF-AF的曲线下面积(AUC)为0.946(95%CI:0.913~0.979,P<0.001),诊断HF-AF的灵敏度为86.8%,特异度为96.5%;以HF-SR组作为对照,MR-proANP诊断HF-AF的AUC为0.662(95%CI:0.588~0.736,P<0.001),灵敏度为68.9%,特异度为60.4%。结论:HF-AF患者组中LAD增大,MR-proANP浓度明显升高。MR-proANP对HF-AF患者具有诊断价值。Objective:To analyze the diagnostic value of plasma atrial natriuretic peptide intermediate fragment(MR-proANP)in patients with heart failure(HF)complicated with atrial fibrillation(AF).Methods:A total of 207 patients with chronic HF who were hospitalized in the Department of Cardiology of Hebei Provincial People’s Hospital were selected,and 57 patients without HF and AF diagnosis but suffering from coronary heart disease and diabetes were included in the control group.HF cases were divided into sinus rhythm HF(HF-SR)group and HF with AF(HF-AF)group according to the presence or absence of AF before hospital,and the differences in basic data of the three groups were compared.The diagnostic value of MR-proANP in HF-AF was evaluated by ROC curve.Results:(1)The differences of MR-proANP among the three groups were statistically significant(P<0.05).(2)The left atrial diameter(LAD)and MR-proANP were significantly different between the HF-AF group and the HF-SR group(P<0.017).(3)ROC analysis showed that in HF-AF patients,with the control group as the control,the area under the curve(AUC)of MR-proANP in the diagnosis of HF-AF was 0.946(95%CI:0.913~0.979,P<0.001),the sensitivity was 86.8%and the specificity was 96.5%.Taking the HF-SR group as a control,the AUC of MR-proANP in the diagnosis of HF-AF was 0.662(95%CI:0.588-0.736,P<0.001),and the sensitivity was 68.9%,and the specificity of 60.4%.Conclusion:The LAD and MR-proANP concentration increased significantly in the HF-AF patients.MR-proANP has diagnostic value in HF-AF patients.

关 键 词：心房利钠肽原中间片段 心力衰竭 心房颤动 诊断 生物标记物 

分 类 号：R541.6[医药卫生—心血管疾病]