摘要
目的:研究氨基末端B型利钠肽(NT-proBNP)水平在心功能分级中的应用。方法:选取2007年11月-2008年4月,复旦大学附属中山医院心血管疾病患者204例(年龄12～90岁),健康人群(对照组)40例(年龄25～65岁)。按照纽约心脏病协会心功能分级(NYHA)将患者分为4组,其中NYHA Ⅰ级33例,NYHA Ⅱ级45例,NYHA Ⅲ级90例,NYHA Ⅳ级36例。测定患者血清NT-proBNP水平,同时进行超声心动图检查,记录患者左心射血分数(LVEF)。分析血清NT-proBNP水平与NYHA分级和LVEF的关系。结果:区分健康人群组和NYHA Ⅰ级疾病组NT-proBNP水平的截点值为136.8ng·L-1,敏感度和特异性分别为88.1%和90.9%;区分NYHA Ⅰ～Ⅱ级和NYHA Ⅲ～Ⅳ级疾病组NT-proBNP水平的截点值为768.8ng·L-1,敏感度和特异性分别为93.4%和87.2%。将对照组和疾病组分别按性别和年龄进行分组统计,结果显示各年龄组别区分健康人群组和NYHA分级疾病组NT-proBNP水平的截点值有所变化,65岁以上各组NT-proBNP水平的截点值显著高于65岁以下同组水平。疾病组LVEF值和血清NT-proBNP水平存在一定的相关性(r=0.699,P<0.01)。结论:血清NT-proBNP可用于NYHA分级。在不同年龄段使用相应的cut-off值,可提高NYHA分级的敏感度和特异性。联合使用NT-proBNP和LVEF值对于NYHA分级有一定的辅助诊断作用。
Objective：To study the use of NT-proBNP in the auxiliary diagnosis of cardiac functional grading. Methods： There were 204 patient（age from 12 to 94） with the cardiovascular diseases enrolled the Zhongshan hospital from the November of 2007 to the April of 2008. There are also 40 healthy people（age from 25 to 65） as the normal control group. These patient were divided into four groups according to the NYHA classification. There were 33 patient in NYHA Ⅰ,45 patient in NYHA Ⅱ,90 patient in NYHA Ⅲand 23 patient in NYHA Ⅳ. The level of the serum NT-proBNP in the five groups was detected by the Roche 2010 chemiluminescence immunoassay assay.The result of LVEF were recorded. The relationship among NT-proBNP,LVEF and NYHA were analyzed by SPSS11.0. Results： The result of ROC curve show that the concentration of NT-proBNP to classify healthy people and the patient with NYHA functional classification was 136.8 ng·L^-1, the sensitivity was 88.1% and the specificity was 90.9%, respectively, the concentration of NT-proBNP to classify NYHA Ⅰ-Ⅱ and NYHA Ⅲ-Ⅳwas 768.8 ng·L^-1, the sensitivity was 93.4% and specificity was 87.2%, respectively. Dividing the apparently healthy individual and the patient with age and sex, the result shows that the cut-off value between apparently healthy individual and NYHA functional classification was different.The cut-off value of NT-ProBNP in those aged ≥65 yearsis higher than those aged ≤65 years obviously. Binary varietic regression analysis showed that there were unvarying correlations between NT-proBNP concentrations and LVEF（r=0.699,P〈0.01）. Conclusion： Serum NT-proBNP can be used in NYHA functional classification. We can use different cut-off according to the age, it can improve the sensitivity and specificity to NYHA functional classification. It has the effect of auxiliary diagnosis to combine NT-proBNP and LVEF in NYHA functional classification.
出处
《中国临床医学》
2009年第2期321-324,共4页
Chinese Journal of Clinical Medicine
关键词
氨基末端B型利钠肽
左心射血分数
纽约心脏病协会心功能分级
N-terminal pro-brainnatriureticpeptide
Left ventricular ejection fraction
NYHA classification grading of cardiac function
