摘要
目的探索N末端脑利钠肽前体(NT-pro BNP)联合胱抑素C(Cys-C)评估慢性肾脏病(CKD)患者心功能的价值。方法收集以CKD为主诊断的165例患者的数据,按肾功能分为5组;探讨血清中NT-pro BNP、Cys-C质量浓度与心肾功能的关系,绘制受试者工作特征曲线(ROC曲线)分析NT-pro BNP、Cys-C和NT-pro BNP联合Cys-C诊断CKD患者慢性心力衰竭(Chronic Heart Failure,CHF)的界值、准确率(AUC值)、敏感度、特异性。结果血清中NT-pro BNP、Cys-C水平随心肾功能分级的增加而升高;Cys-C与NT-pro BNP呈正相关性(r=0.687,P<0.05);NT-pro BNP、Cys-C诊断CKD患者CHF的界值随着肾功能分期的增加而增加;NT-pro BNP联合Cys-C诊断CKD患者CHF的准确率优于NT-pro BNP、Cys-C单独检测。结论血清中NT-pro BNP、Cys-C水平会受到心肾功能的影响,NT-pro BNP联合Cys-C可提高诊断CKD患者CHF的准确率。建议对CKD患者应用NT-pro BNP联合Cys-C进行心功能评估,同时应结合肾功能情况采用不同的诊断界值。
Objective To explore the value of N-Terminal pro-Brain Natriuretic Peptide(NT-pro BNP)combined with Cystatin C(Cys-C)in evaluating cardiac function with chronic kidney disease(CKD).Methods A total of 165patients with CKD were collected,and divided into 5groups according to the renal function.On this basis,the relationship between the level of NT-pro BNP and Cys-C in serum with cardiac-renal function are detected,and the threshold,accuracy(AUC),sensitivity and specificity of NT-pro BNP combined with Cys-C in the diagnosis of Chronic Heart Failure(CHF)with CKD are analyzed based on Receiver Operator Characteristic curve(ROC).Results The level of NT-pro BNP and Cys-C in serum increases with the deterioration of cardiac-renal function(P<0.05).The level of NT-pro BNP and Cys-C are positively correlated with each other(r=0.687,P<0.05).The cut-off value of CHF with CKD diagnosed by NT-pro BNP and Cys-C increases with the deterioration of renal function(P<0.05).The AUC values of each renal function stage detected by NT-pro BNP combined with Cys-C are higher than those detected by NT-pro BNP and Cys-C separately.Conclusion The level of NT-pro BNP and Cys-C in serum are affected by cardiac-renal function.The accuracy of diagnosis of HF with CKD can be improved by combining NT-pro BNP with Cys-C.Simultaneously,the difference of cut-off value in different stage of renal function need to be considered.
作者
王精文
张欢
赵冠杰
刘锋
WANG Jing-wen;ZHANG Huan;ZHAO Guan-jie(Department of Nephrology,China-Japan Union Hospital of JiLin University,ChangChun130033,China)
出处
《中国实验诊断学》
2020年第10期1598-1601,共4页
Chinese Journal of Laboratory Diagnosis
