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B型尿钠肽对无ST段抬高急性心肌梗死患者的诊断价值
引用本文:刘泽金,王纯,张真路,张淑琴. B型尿钠肽对无ST段抬高急性心肌梗死患者的诊断价值[J]. 诊断学理论与实践, 2006, 5(5): 412-414. DOI: 10.16150/j.1671-2870.a1014
作者姓名:刘泽金  王纯  张真路  张淑琴
作者单位:武汉亚洲心脏病医院检验中心,武汉亚洲心脏病医院检验中心,武汉亚洲心脏病医院检验中心,武汉大学人民医院 湖北武汉430022,湖北武汉430022,湖北武汉430022,湖北武汉430064
摘    要:目的:评价B型尿钠肽(BNP)对伴急性胸痛但心电图无ST段抬高的急性心肌梗死(AMI)患者的诊断价值。方法:对156例门诊及急诊急性胸痛或胸部不适患者进行前瞻性研究,测定BNP和肌钙蛋白I(cTnI),评价BNP对无ST段抬高的AMI患者的早期诊断价值。结果:156例患者中,不伴有心电图ST段抬高AMI患者,其入院时BNP水平显著高于不稳定型心绞痛和非急性冠状动脉综合征患者。BNP诊断无ST段抬高的AMI的敏感度为0.63,特异度为0.42。联合应用BNP及cTnI可显著提高对无ST段抬高AMI的诊断敏感度(0.99),阴性预测值可提高至0.98。经多元回归分析发现,对于诊断无ST段抬高AMI,BNP是一个显著的独立指标。结论:对于伴有急性胸痛但无ST段抬高的AMI患者,尤其是cTnI还未达到AMI诊断阈值时,BNP联合cTnI可能成为其有效的早期诊断指标之一。

关 键 词:B型尿钠肽  肌钙蛋白I  急性心肌梗死  诊断价值  
文章编号:1671-2870(2006)05-0412-03
收稿时间:2006-07-11
修稿时间:2006-07-11

Diagnostic value of B-type natriuretic peptide in the acute myocardial infarction patients without ST segment elevation
LIU Ze-jin,WANG Chun,ZHANG Zhen-lu,ZHANG Shu-qin. Diagnostic value of B-type natriuretic peptide in the acute myocardial infarction patients without ST segment elevation[J]. Journal of Diagnostics Concepts & Practice, 2006, 5(5): 412-414. DOI: 10.16150/j.1671-2870.a1014
Authors:LIU Ze-jin  WANG Chun  ZHANG Zhen-lu  ZHANG Shu-qin
Abstract:Objective To investigate the diagnostic value of B-type natriuretic peptide(BNP) in the acute myocardial infarction(AMI) patients with chest pain but without ST-segment elevation. Methods A prospective study involving 156 patients with chest pain or chest indisposition was conducted in the out-patient department and the emergency department. The concentrations of BNP and cardiac troponin I(cTnI) were evaluated at their admission. Results Ninety-four patients had AMI without ST elevation, whose BNP level at their admission was significantly higher than that of the patients with unstable angina or non-acute coronary syndrome. The sensitivity and the specificity of BNP for non-ST AMI were 0.63 and 0.42, respectively. BNP in combination with cTnI significantly elevated the sensitivity of diagnosis to 0.99, and the negative predictive value to 0.98. Multiple logistic regression analysis showed that BNP at the patieats' admission was a significant independent predictor for non-ST AMI. Conclusions BNP at the patieats' admission is possibly a useful and competent predictor for AMI patients with chest pain but without ST segment elevation, especially for patients whose cTnI value is just beyond the upper limit of normal range but still under the cutoff value.
Keywords:B-type natriuretic peptide  Cardiac troponin I  Acute myocardial infarction  Dianostic value
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