血清NT-proBNP和Cys-C水平联合检测在心力衰竭诊断与分型中的应用

目的 探讨血清氨基末端B型脑钠肽(NT-proBNP)和胱抑素-C( Cys-C)水平联合检测在心力衰竭诊断与分型中的应用。方法 选取心力衰竭诊断明确的75例患者为试验组,选取同期查体健康者75例为对照组。用双向侧流免疫法检测血清NT-proBNP水平; 用乳胶免疫比浊法检测Cys-C水平,通过统计学分析观察其差异性和相关性。结果 试验组血清NT-proBNP为816±338 pg/ml,Cys-C为1.28±0.34 mg/L,对照组血清NT-proBNP为38.2±19.9 pg/ml,Cys-C为0.72±0.17mg/L,试验组患者血清联合检测水平均高于对照组患者水平,差异均有统计学意义(t=33.6,12.6,均P<0.05); 试验组按NYHA心功能分级与对照组比较,差异均有统计学意义(F=43.2,26.6,均P<0.05); 血清NT-proBNP和Cys-C联合检测明显提高对心力衰竭诊断的敏感度和特异度,差异均有统计学意义(r=0.58,均P<0.05)。结论 血清NT-proBNP和Cys-C水平联合检测是心力衰竭诊断与分型的重要检测指标,为实验室心力衰竭诊断比较理想的应用组合。

Application of Combined Detection of Serum NT-proBNP and Cys-C Levels in Diagnosis and Typing of Heart Failure

Objective To investigate the application of combined detection of serum N-terminal B-type natriuretic peptide(NT-proBNP)and cystatin-C(Cys-C)in the diagnosis and classification of heart failure.Methods 75 patients with heart failure were selected as theexperimental group and 75 healthy subjects were selected as the control group.Serum NT-proBNP level was detected by bidirectional flow immunoassay,and Cys-Clevel was detected by latex immunoturbidimetry.The difference and correlationwere observed by statistical analysis.Results The levelsof NT-proBNP and Cys-C in the experimental group and the control group were 816±338 pg/ml,1.28±0.34 mg/L; 38.2±19.9 pg/ml,0.72±0.17 mg/L respectively.Compared with the control group,the difference of functional classificationwas statistically significant(F=43.2,26.6,all P<0.05),and the combined detection of NT-proBNP and Cys-C significantly increased the sensitivityand specificity of the diagnosis of heart failure(r=0.58,all P<0.05).Conclusion The combined detection of serum NT-proBNPand Cys-C levels is an important index for the diagnosis and typing of heart failure,and is an ideal combination for laboratory diagnosis of heart failure.