B型利钠肽在心力衰竭诊断和心功能评估中的临床价值

目的探讨B型利钠肽(BNP)水平测定在心力衰竭(HF)诊断和心功能评估中的临床应用价值。方法选择38例心衰患者及42例正常人,行超声心动图检查,测定左室舒张末径(LVEDD),以简化双平面Simpson法计算出左室射血分数(LVEF),同时测定静脉全血BNP水平,心衰患者治疗3￣4周后复查超声心动图和BNP,观察治疗前后各项指标的变化及BNP水平与LVEF、LVEDD的相关性。结果心衰组BNP水平明显高于正常对照组(P<0.01),心衰患者治疗后BNP明显下降(P<0.01),BNP水平与LVEF之间显著负相关(!=-0.72,P<0.01),与LVEDD呈正相关,(!=0.45,P<0.01)。BNP水平诊断心力衰竭ROC曲线下面积为0.987。以96.35ng/L为界值,BNP水平诊断心衰的敏感度为92.7%,特异度为94.1%,准确度为91.4%。结论BNP水平测定有助于心力衰竭诊断和心功能的评估。

Clinical value of B-type natriuretic peptide in diagnosis of heart failure and assessment of heart function

Objective:To investigate the value of B-type natriuretic peptide(BNP)level in diagnosis of heart failure(HF)and assessment of heart function. Methods:Thirty eight HF patients and 42 normal controls were determined left ventricular end-diastole dimension(LVEDD)by echocardiography,left ventricular ejection fraction(LVEF)by Simpson's formula.Venous blood BNP level was detected simultaneously.After treatment for 3-4 weeks,all of the HF patients were determined echocardiography and BNP level again.To observe the changes of all indexes,and the correlation between BNP level and LVEF,LVEDD.Results:The BNP level in the HF group was obviously higher than controls(P<0.01).The BNP level was decreased in HF group after treatment(P<0.01).BNP level had negative correlation with LVEF(=-0.72,P<0.01)and positive correlation with LVEDD(=0.45,P<0.01).Area under the ROC curve was 0.987 of BNP level for diagnosis of heart failure.Accepting the BNP standard as 96.35ng/L,the sensitivity,specificity and accuracy rating were 92.7%,94.1% and 91.4% respectivly.Conclusion:The BNP level is helpful to diagnose HF and assess heart function .