舒张性心功能不全患者血浆NT-proBNP、血清hs-CRP和cTnI检验的临床意义研究  

Clinical Significance of Plasma NT-proBNP,Serum hs-CRP and cTnI in Patients with Diastolic Cardiac Dysfunction

作　　者：张丽 张文凤 屈允月 ZHANG Li;ZHANG Wenfeng;QU Yunyue(Department of Clinical Laboratory,Tengzhou Hospital of Traditional Chinese Medicine,Tengzhou 277500,Shandong,China)

机构地区：[1]滕州市中医医院检验科,山东滕州277500

出　　处：《系统医学》2024年第24期20-23,32,共5页Systems Medicine

摘　　要：目的 探讨舒张性心功能不全患者血浆氨基末端脑利钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)、血清超敏C反应蛋白(hypersensitive C-reactive protein, hs-CRP)和肌钙蛋白I(cardiac troponin I,cTnI)检验的临床意义。方法 非随机选取2022年1月—2024年1月滕州市中医医院的68例舒张性心功能不全患者(心功能不全组)和50名健康体检者(对照组),均行血浆NT-proBNP、血清hs-CRP和cTnI检验,并根据纽约心脏病学会心功能分级标准将舒张性心功能不全患者分为I级组(n=20)、II级组(n=31)、III~IV级组(n=17),比较各组血浆NT-proBNP、血清hs-CRP和cTnI水平,并通过ROC曲线分析上述指标对舒张性心功能不全的诊断价值。结果 心功能不全组血浆NT-proBNP、血清hs-CRP和cTnI水平均高于对照组,差异有统计学意义(P均<0.05)。心功能分级为III~IV级舒张性心功能不全患者血浆NT-proBNP、血清hs-CRP和cTnI水平均高于II级组和I级组,差异有统计学意义(P均<0.05)。ROC曲线分析显示,血浆NT-proBNP、血清hsCRP和cTnI对老年舒张性心功能不全的诊断AUC(95%CI)分别为0.797(0.720~0.874)、0.764(0.683~0.845)、0.825(0.756~0.894),敏感度为79.5%、72.3%、79.5%,特异度为68.8%、72.1%、74.6%;上述指标联合检测对老年舒张性心功能不全的诊断AUC(95%CI)为0.969(0.933~0.994),敏感度、特异度分别为90.0%、91.2%,均高于各项指标单独检测。结论 老年舒张性心功能不全血浆NT-proBNP、血清hs-CRP和cTnI水平较高,且与心功能分级密切相关,联合检测可提高舒张性心功能不全的早期诊断效能。Objective To investigate the clinical significance of testing N-terminal pro brain natriuretic peptide(NT-proBNP),serum hypersensitive C-reactive protein(hs-CRP),and cardiac troponin I(cTnI)in patients with diastolic heart failure.Methods A total of sixty-eight patients with diastolic cardiac dysfunction admitted to Tengzhou Hospital of Traditional Chinese Medicine from January 2022 to January 2024(cardiac dysfunction group)and fifty healthy physical examination(control group)were non-randomly selected.Plasma NT-proBNP,serum hs-CRP and cTnI tests were performed.The patients with diastolic cardiac dysfunction were divided into grade I group(n=20),Grade II group(n=31)and Grade III-IV group(n=17)according to the cardiac function grading criteria formulated by the New York College of Cardiology(NYHA).The levels of plasma NT-proBNP,serum hs-CRP and cTnI in each group were com‐pared.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of plasma NT-proBNP,serum hs-CRP and cTnI in diastolic cardiac dysfunction.Results The levels of plasma NT-proBNP,serum hs-CRP and cTnI in cardiac dysfunction group were higher than those in control group,the differences were statisti‐cally significant(all P<0.05).The levels of plasma NT-proBNP,serum hs-CRP and cTnI in patients with diastolic car‐diac dysfunction of grade III to IV were higher than those in grade II and Grade I groups,the differences were statisti‐cally significant(all P<0.05).ROC curve analysis showed that the AUC(95%CI)of plasma NT-proBNP,serum hs-CRP and cTnI for the diagnosis of senile diastolic cardiac dysfunction were 0.797(0.720~0.874),0.764(0.683~0.845)and 0.825(0.756~0.894),the predictive sensitivity was 79.5%,72.3%,79.5%,and the specificity was 68.8%,72.1%,74.6%.The AUC(95%CI)for the diagnosis of diastolic cardiac dysfunction in the elderly was 0.969(0.933-0.994),and the sensitivity and specificity were 90.0%and 91.2%,which were higher than that of each index alone.Conclu-sion The levels of plasma NT-proBNP,serum hs-CRP a

关 键 词：舒张性心功能不全 血浆氨基末端脑利钠肽前体 超敏C反应蛋白 肌钙蛋白I 

分 类 号：R446.1[医药卫生—诊断学]