血浆脑钠肽在高龄老年射血分数正常心力衰竭患者中的应用

目的探讨血浆脑钠肽（brain natriuretic peptide，BNP）在老年射血分数正常心力衰竭（nomal ejection fraction heart failure，NEFHF）患者中的诊断价值。方法采集年龄大于75岁的NEFHF老年患者117例及正常老年人71例血样，检测BNP浓度，同时行心脏超声检查，比较NEFHF患者与正常人的血浆BNP浓度并作受试者工作特征曲线分析，同时分析BNP与心脏舒张功能障碍分级的关系。结果老年NEFHF患者血浆BNP浓度显著高于正常老年人（P〈0．01），其诊断老年NEFHF的曲线下面积0．746（95％cI：0．677-0．815），取1500psiml作为界值的灵敏度为68％，特异度为62％，血浆BNP浓度与舒张功能障碍的分级显薯相关（P〈0．01）。结论血浆BNP水平在老年NEFHF患者中显著升高．具有较高的诊断价值。

The diagnostic value of plasma BNP in the senile patients with normal eject fraction heart failure

Objective To investigate the diagnostic value of plasma brain natriuretic peptide(BNP) in senile patients with normal eject fraction heart failure(NEFHF).Methods The blood samples in 117 senile patients(age >75 years) with NEFHF and 71 healthy senile volunteers(age >75 years) were collected,and the concentrations of BNP in the blood samples were detected by electrochemiluminescence immunoassay,at the same time,the parameters including LVEF,E/A,E/Vp were detected by echocardiography.The changes of concentration of plasma BNP in patients with NEFHF were observed and compared with those in healthy senile subjects,and the performance curve was analyzed for all the subjects,furthermore,the correlation between BNP and cardiac diastolic dysfunction classification was analyzed.Results The levels of plasma BNP in the senile patients with NEFHF were significantly higher than those in healthy senile subjects(P<0.01),and the area under curve which was used to diagnose NEFHF was 0.746(95%CI:0.677~0.815).When the cut off value was 1 500pg/ml,the diagnostic sensitivity and specificity were 68% and 62%,respectively.The levels of BNP were closely correlated with cardiac diastolic dysfunction classification.Conclusion The levels of plasma BNP are obviously increased in senile patients with NEFHF,which has important diagnostic value.