NT-proBNP在多发性骨髓瘤诊断中的应用研究

目的研究血清N端前脑钠肽(NT-proBNP)水平在多发性骨髓瘤中的诊断价值。方法收集整理徐州医科大学附属医院2017年12月至2018年12月门诊及住院明确诊断为多发性骨髓瘤并同时检测了M蛋白和血清NT-proBNP的患者共132例,并将收集的132例按NT-proBNP值分低值、中值、高值3个小组,另外收集同时检测了M蛋白和血清NT-proBNP的健康体检者132例作为健康对照组。用SPSS18.0软件通过箱体图、秩和检验和ROC曲线对相应数据进行分析统计。结果多发性骨髓瘤患者低值、中值、高值3组NTproBNP水平都高于健康对照组,组间差异均有统计学意义(P<0.01)。以M蛋白电泳为金标准,分析NTproBNP对多发性骨髓瘤的诊断价值,做ROC曲线,其ROC曲线下面积为0.899,NT-proBNP最佳诊断临界值为1 381.0pg/mL,用该值诊断多发性骨髓瘤的灵敏度为76.9%,特异度为84.6%。结论 NT-proBNP在多发性骨髓瘤辅助诊断中具有重要的临床意义,且通过ROC曲线分析,可以发现其诊断多发性骨髓瘤的灵敏度、特异度较高,为多发性骨髓瘤的诊断提供另一种简单的有效途径。

Application of NT-proBNP in diagnosis of multiple myeloma

Objective To study the correlation between the serum NT-proBNP level and multiple myeloma(MM).Methods A total of 132 outpatients and inpatients with definitely diagnosed MM in the Affiliated Hospital of Xuzhou Medical College from December 2017 to December 2018 were collected and sorted out,in which the M protein and the serum NT-proBNP level detection were simultaneously performed.The 132 collected cases were divided into the low,middle and high value groups according to the serum NT-proBNP value.At the same time 132 persons undergoing the healthy physical examination healthy examinees with simultaneous detection of M protein electrophoresis and serum NT-proBNP detection were collected as the healthy control group.The SPSS18.0 software was used to statistically analyze the corresponding data through the box diagram,rank sum test and ROC curve.Results The NT-proBNP level in the low,middle and high groups was higher than that in the healthy control group,and the differences among the three groups were statistically significant(P<0.01).With the M protein electrophoresis as the gold standard,the diagnostic value of NTproBNP was analyzed.The ROC curve was drawn.The area under ROC curve was 0.899.The optimal diagnostic critical value of NT-proBNP was 1 381.0 pg/mL.The sensitivity and specificity of this value for diagnosing MM were 76.9%and 84.6%,respectively.Conclusion NT-proBNP has an important clinical significance in the assistant diagnosis of MM.Through the analysis of ROC curve,it can be found that sensitivity and specificity of NT-proBNP are hgiher in diagnosing MM,which provides another simple and effective way for the diagnosis of MM.