N-末端B型利钠肽原在老年慢性心力衰竭诊断中的应用

目的 探讨N-末端B型利钠肽原(NT-proBNP)水平与老年慢性心力衰竭的关系及其临床意义.方法 采用电化学发光免疫法检测129例老年患者,根据临床病史、症状、体征、客观检查作出诊断,并按美国纽约心脏病学会(NYHA)分级方案将心功能分为4级.比较非心衰和心衰老年患者NT-proBNP水平并进行对照分析.结果 血清NT-proBNP水平均呈偏态分布.不同性别、同一性别、不同年龄的体检健康者血清NT-proBNP水平差异有统计学意义(P＜0.05);心衰组血清NT-proBNP水平明显高于非心衰疾病对照组和健康对照组,差异均有统计学意义(P<0.05).各级心衰组右心室射血分数(LVEF)与NT-proBNP呈负相关(P<0.05);以900、1 800 pg/mL为临界值,LVEF以50%为临界值,其诊断心衰的灵敏度分别为87.7%和46.8%.结论 NT-proBNP检测结果可靠,检测水平与NYHA分级及LVEF有良好的相关性,NT-proBNP检测比LVEF更灵敏.

Clinical application of N-terminal-pro-B-type natriuretic peptide for the diagnosis of chronic heart failure in aged patients

Objective To investigate correlation between N-terminal B-type natriuretic peptide(NT-proBNP) and chronic heart failure(CHF) in aged patients and its clinical significance.Methods 129 cases of aged patients,with diagnosis based on clinical history,symptoms,signs and objective examination,and divided into 4 groups according to New York Heart Association(NYHA) classification scheme.NT-proBNP level was compared between non-heart failure and heart failure groups.Results Serum NT-proBNP level showed a skewed distribution.In healthy subjects,serum NT-proBNP level was statistical different between different gender and age groups(P<0.05).Serum NT-proBNP level in heart failure group was higher than that in non-heart failure group and healthy control group(P<0.05).There was negative correlation between left ventricular ejection fraction(LVEF) and NT-proBNP in heart failure group at different NYHA classification(P<0.05).Taking 900 and 1 800 pg/mL as cut-off value of NT-proBNP and 50% as cut-off value of LVEF,the diagnostic sensitivity for heart failure were 87.7% and 46.8%.Conclusion NT-proBNP could be a reliable index,with fine correlation with NYHA classification and LVEF,and more sensitive than LVEF.