无器质性心脏病者血浆N末端B型利钠肽原浓度及其影响因素

目的 探讨成年人血浆N末端B型利钠肽原(NT-proBNP)的正常参考值范围及影响因素.方法 选择常规临床检查和冠状动脉造影正常的成年人300例,用酶联免疫吸附法检测血浆NT-proBNP浓度.以每10岁为一个年龄组,比较各年龄组间和相同年龄组的男女间血浆NT-proBNP浓度的差异,并分别比较有与无高血压病、糖尿病及超重者的血浆NT-proBNP浓度.用多元逐步回归分析方法,分析血浆NT-proBNP浓度的影响因素.并计算血浆NT-proBNP浓度的正常参考值.结果 在正常成年人,血浆NT-proBNP浓度在男性60岁以上者随年龄升高而升高(P<0.05),而在男性60岁以下者和女性则不随年龄变化而变化(均P>0.05).男女间比较,血浆NT-proBNP浓度在60岁以下女性高于男性(P<0.05),而60岁以上则男性高于女性(P<0.05).有与无高血压病、糖尿病及超重者间分别比较血浆NT-proBNP浓度均无统计学差异(均P>0.05).多元逐步回归分析表明,年龄是血浆NT-proBNP浓度的独立预测因素(P<0.01).血浆NT-proBNP浓度的正常参考值范围在60岁以下男女分别为160～470 pmol/L和170～660 pmol/L,60岁以上男女分别为180～760pmol/L和180～560 pmol/L,总体为160～600 pmol/L.结论 在无器质性心脏病并且肾功能正常的成年人,血浆NT-proBNP浓度有性别差异,并在60岁以上男性随年龄增长而增加.

Plasma N-terminal pro-B-type natriuretic peptide reference value in subjects without heart diseases

Objective To determine the reference value of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) in subjects without heart diseases. Methods The plasma concentration of NT-proBNP was measured with ELISA method in 300 adults excluded heart disease through various examinations including electrocardiography, echocardiography, X-ray and coronary artery angiography. The plasma NT-proBNP concentration was compared between age-groups 30-39, 40-49, 50-59, 60-69 and ≥70 years old, between male and female in the same age-group and between subjects with and without hypertension, diabetes and obesity. A multiple linear regression analysis was used to detect factors influencing NT-proBNP among age, sex, body mass index, blood pressure, heart rate, serum creafinine, hypertension, diabetes mellitus, use of angiotensin-converting-enzyme inhibitors, Ca2+ -antagonist, and β-blocker. Results The plasma NT-proBNP concentration increased in proportion to aging in male subjects more than 60 years old (P < 0.05), remained unchanged in males less than 60 years old and females (P > 0.05 ). Plasma NT-proBNP concentration was significantly higher in female (170-660 pmol/L) than in male (160-470 pmol/L) in subjects less than 60 years old (P<0.05) and significantly lower in female (180-560 pmol/L) than in male (180-760 pmol/L) in subjects more than 60 years old (P < 0.05). Multiple linear regression analysis demonstrated that age was the only independent predictor for plasma NT-proBNP in these subjects (P < 0.01). Conclusion The plasma concentration of NT-proBNP in subjects without heart diseases was different between male and female, and was increasing with age in male subjects more than 60 years old.