无症状性心功能不全患者血浆脑利钠肽的临床研究

张先林; 张恒; 蔡鑫; 包宗明; 王洪巨; 马宾; 宋伟; 王凤超

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无症状性心功能不全患者血浆脑利钠肽的临床研究

张先林 , 张恒 , 蔡鑫 , 包宗明 , 王洪巨 , 马宾 , 宋伟 , 王凤超

文章导航 > 蚌埠医学院学报 > 2010, 35 > 2: (127-129)

引用本文:

Citation:

无症状性心功能不全患者血浆脑利钠肽的临床研究

1. 安徽省马鞍山市人民医院心内科, 243000;
2. 蚌埠医学院第一附属医院心内科, 安徽蚌埠 233004;
3. 蚌埠医学院第一附属医院心脏彩超室, 安徽蚌埠 233004;
4. 蚌埠医学院第一附属医院检验中心, 安徽蚌埠 233004

作者简介: 张先林(1981-),男,硕士,住院医师.

基金项目:
安徽省教育厅自然科学研究计划项目(2004kj284)
中图分类号: R541.61

Diagnostic value of plasma brain natriuretic peptide in asymptomatic heart failure

1. Department of Cardiology, Maanshan People's Hospital, Maanshan Anhui 243000;
2. Department of Cardiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China;
3. Department of Echocardiogram, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China;
4. Laboratory Center, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China
CLC number: R541.61

摘要: 目的:探讨血浆脑利钠肽(brain natriuretic peptide,BNP)对无症状性心功能不全(asymptomatic heart failure,AHF)的诊断价值及血浆BNP与心功能不全相关性的临床研究。方法:将140例观察对象分为3组,AHF组50例,充血性心力衰竭(congestive heart failure,CHF)组50例,健康对照组40例。检测3组血浆BNP水平,并行超声心动图检查。AHF组及对照组均进行活动平板运动试验,并分别于运动后立即抽取静脉血观察BNP变化情况。应用多变量相关分析法分析影响BNP水平的相关因素,采用受试者工作特征曲线(receiver operating characteristic,ROC)分析BNP诊断AHF的准确性。结果:CHF组BNP水平显著高于AHF组及对照组(P<0.01),AHF组与对照组差异无统计学意义(P>0.05)。运动后AHF组BNP增加(△BNP)程度显著高于对照组(P<0.01)。多变量相关分析提示,血浆BNP水平与NYHA心功能分级呈正相关关系(r=0.534,P<0.01),与左心室射血分数(LVEF)呈负相关关系(P<0.01)。ROC曲线分析显示运动前、后BNP及△BNP曲线下面积分别为0.653(P<0.05)、0.724(P<0.01)、0.831(P<0.01)。若取△BNP为58.90pg/ml,其诊断AHF的敏感性和特异性分别为80%和75%。结论:血浆BNP水平是CHF敏感而特异的诊断指标,且与LVEF呈负相关,与NYHA心功能分级呈正相关,能很好地反映心功能状态变化,并可判断CHF的严重程度。BNP结合运动试验能提高AHF的诊断敏感性和特异性。
- 心力衰竭,充血性 /
- 利钠肽,脑 /
- 激素类/治疗应用
Abstract: Objective:To assess the value of brain natriuretic peptide(BNP) in diagnosis of asymptomatic heart failure(AHF), and to study the relationship between BNP and heart failure.Methods:One hundred and forty subjects were divided into AHF group(50 cases),congestive heart failure(CHF) group(50 cases) and healthy control(40 cases).The plasma BNP was measured, and echocardiogram was performed in all the cases.Exercise treadmill testing was carried on in the patients with AHF and the healthy controls,and the plasma BNP was determined immediately after exercise testing.Multi-variable correlation analysis was used to determine the relationship between BNP and different variables;receiver operating characteristic curves were used to assess the diagnostic accuracy of BNP in detecting AHF.Results:The plasma BNP concentration in CHF group was significantly higher than that in AHF group and control group(P<0.01),but there was no significant difference between AHF group and control group(P>0.05).After exercise testing,the BNP(△BNP) in AHF group increased significantly compared with that in control group(P<0.01).Multi-variable correlation analysis showed that BNP concentrations were positively related to NYHA functional classifications(r=0.534,P<0.01) and negatively related to LVEF(P<0.01).The area under the curve before and after exercise testing and △BNP were 0.653(P<0.05),0.724(P<0.01) and 0.831(P<0.01),respectively.If the value of △BNP was 58.90 pg/ml,the sensitivity and specificity would be 80% and 75% in detecting AHF.Conclusions:BNP is a sensitive and specific diagnostic marker of CHF.Natriuretic peptide concentration is negatively correlated with LVEF and positively with NYHA functional classifications.Plasma BNP can reflect the changes of cardiac function,and can be used to assess the severity of heart failure.BNP combined with exercise testing may enhance the diagnosis of AHF.
- heart failure,congestive /
- natriuretic peptide,brain /
- hormone/treatment application

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无症状性心功能不全患者血浆脑利钠肽的临床研究

作者简介: 张先林(1981-),男,硕士,住院医师.

1. 安徽省马鞍山市人民医院心内科, 243000;
2. 蚌埠医学院第一附属医院心内科, 安徽蚌埠 233004;
3. 蚌埠医学院第一附属医院心脏彩超室, 安徽蚌埠 233004;
4. 蚌埠医学院第一附属医院检验中心, 安徽蚌埠 233004

收稿日期: 2008-11-02

基金项目: 安徽省教育厅自然科学研究计划项目(2004kj284)

关键词:

摘要: 目的:探讨血浆脑利钠肽(brain natriuretic peptide,BNP)对无症状性心功能不全(asymptomatic heart failure,AHF)的诊断价值及血浆BNP与心功能不全相关性的临床研究。方法:将140例观察对象分为3组,AHF组50例,充血性心力衰竭(congestive heart failure,CHF)组50例,健康对照组40例。检测3组血浆BNP水平,并行超声心动图检查。AHF组及对照组均进行活动平板运动试验,并分别于运动后立即抽取静脉血观察BNP变化情况。应用多变量相关分析法分析影响BNP水平的相关因素,采用受试者工作特征曲线(receiver operating characteristic,ROC)分析BNP诊断AHF的准确性。结果:CHF组BNP水平显著高于AHF组及对照组(P<0.01),AHF组与对照组差异无统计学意义(P>0.05)。运动后AHF组BNP增加(△BNP)程度显著高于对照组(P<0.01)。多变量相关分析提示,血浆BNP水平与NYHA心功能分级呈正相关关系(r=0.534,P<0.01),与左心室射血分数(LVEF)呈负相关关系(P<0.01)。ROC曲线分析显示运动前、后BNP及△BNP曲线下面积分别为0.653(P<0.05)、0.724(P<0.01)、0.831(P<0.01)。若取△BNP为58.90pg/ml,其诊断AHF的敏感性和特异性分别为80%和75%。结论:血浆BNP水平是CHF敏感而特异的诊断指标,且与LVEF呈负相关,与NYHA心功能分级呈正相关,能很好地反映心功能状态变化,并可判断CHF的严重程度。BNP结合运动试验能提高AHF的诊断敏感性和特异性。

English Abstract

Diagnostic value of plasma brain natriuretic peptide in asymptomatic heart failure

1. Department of Cardiology, Maanshan People's Hospital, Maanshan Anhui 243000;
2. Department of Cardiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China;
3. Department of Echocardiogram, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China;
4. Laboratory Center, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China

Received Date: 2008-11-02

Abstract: Objective:To assess the value of brain natriuretic peptide(BNP) in diagnosis of asymptomatic heart failure(AHF), and to study the relationship between BNP and heart failure.Methods:One hundred and forty subjects were divided into AHF group(50 cases),congestive heart failure(CHF) group(50 cases) and healthy control(40 cases).The plasma BNP was measured, and echocardiogram was performed in all the cases.Exercise treadmill testing was carried on in the patients with AHF and the healthy controls,and the plasma BNP was determined immediately after exercise testing.Multi-variable correlation analysis was used to determine the relationship between BNP and different variables;receiver operating characteristic curves were used to assess the diagnostic accuracy of BNP in detecting AHF.Results:The plasma BNP concentration in CHF group was significantly higher than that in AHF group and control group(P<0.01),but there was no significant difference between AHF group and control group(P>0.05).After exercise testing,the BNP(△BNP) in AHF group increased significantly compared with that in control group(P<0.01).Multi-variable correlation analysis showed that BNP concentrations were positively related to NYHA functional classifications(r=0.534,P<0.01) and negatively related to LVEF(P<0.01).The area under the curve before and after exercise testing and △BNP were 0.653(P<0.05),0.724(P<0.01) and 0.831(P<0.01),respectively.If the value of △BNP was 58.90 pg/ml,the sensitivity and specificity would be 80% and 75% in detecting AHF.Conclusions:BNP is a sensitive and specific diagnostic marker of CHF.Natriuretic peptide concentration is negatively correlated with LVEF and positively with NYHA functional classifications.Plasma BNP can reflect the changes of cardiac function,and can be used to assess the severity of heart failure.BNP combined with exercise testing may enhance the diagnosis of AHF.