中段心房利钠肽原对呼吸困难人群心力衰竭的诊断价值

杨爱龙; 周露露; 陈曦; 高宏伟

doi:10.13898/j.cnki.issn.1000-2200.2017.12.017

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中段心房利钠肽原对呼吸困难人群心力衰竭的诊断价值

杨爱龙 , 周露露 , 陈曦 , 高宏伟

文章导航 > 蚌埠医学院学报 > 2017, 42 > 12: (1627-1629,1633)

引用本文:

Citation:

中段心房利钠肽原对呼吸困难人群心力衰竭的诊断价值

北京军区总医院263临床部, 北京 101149

作者简介: 杨爱龙(1977-),男,副主任技师.

中图分类号: R541.6

Diagnostic value of MR-proANP for heart failure in dyspnea patients

The 263 Clinical Branch of the Army General Hospital, Beijing 101149, China
CLC number: R541.6

摘要: 目的：评价中段心房利钠肽原（MR-proANP）对呼吸困难人群心力衰竭（心衰）的诊断价值。方法：前瞻性纳入203例因呼吸困难就诊的病人，包括96例心衰病人和107例非心衰病人。以KRYPTOR平台检测病人就诊时血浆中MR-proANP水平。采用受试者工作特征曲线法分析MR-proANP对心衰的诊断价值，同时与B型利钠肽前体N端（NT-proBNP）进行比较。采用logistic回归模型将NT-proBNP和MR-proANP合并为一个参数（NT-proBNP+MR-proANP），并分析其诊断心衰的准确性。分析纽约心脏病协会（NYHA）心功能分级、NT-proBNP水平与MR-proANP的相关性。并收集120名健康体检者的血浆，用于分析MR-proANP的参考范围。结果：心衰病人血浆MR-proANP水平明显高于非心衰病人（P<0.01）。NT-proBNP ROC曲线下面积与MR-proANP差异无统计学意义（P>0.05）。NT-proBNP和MR-proANP联合诊断心衰的ROC曲线下面积均高于MR-proANP和NT-proBNP曲线下面积（P<0.05）。MR-proANP的最佳诊断界值为100 pmol/L，对应的诊断敏感性（95%CI）和特异性（95%CI）分别为0.91（0.83~0.96）和0.64（0.55~0.74）。随着NYHA心功能分级的升高，心衰病人血浆MR-proANP水平增加（P<0.01）。MR-proANP和NT-proBNP呈正相关关系（r_s=0.64，P<0.01）。结论：MR-proANP对呼吸困难人群心衰的诊断具有一定帮助。联合MR-proANP和NT-proBNP可以提高心衰的诊断准确性。
- 心力衰竭 /
- 呼吸困难 /
- 中段心房利钠肽原断
Abstract: Objective:To explore the diagnostic value of midregion of pro-atrial natriuretic peptide(MR-proANP) for heart failure in dyspnea patients.Methods:The serum levels of MR-proANP in 203 dyspnea patients[including 96 heart failure(HF) patients and 107 non-HF patients] on admission was determined by KRYPTOR platform.The diagnostic value of MR-proANP for HF was analyzed using receiver operating characteristic(ROC) curve,and which was compared with amino-terminal pro-B type natriuretic peptide(NT-proBNP).The MR-proANP and NT-proBNP were combined into an index using logistic regression model,which was used to analyze its diagnostic accuracy for HF.The relationships between cardiac function of New York Heart Association(NYHA),NT-proBNP and MR-proANP were analyzed.The reference range of MR-proANP was established by 120 healthy examinees.Results:The serum level of MR-proANP in HF patients was higher than that in non-HF patients(P<0.01).The difference of the area under ROC curve between NT-proBNP and MR-proANP was not statistically significant(P>0.05).The area under ROC curve of the joint diagnosis of heart failure with NT-proBNP and MR-proANP was higher than that in MR-proANP or NT-proBNP(P<0.05).The optimal threshold,sensitivity and specificity of MR-proANP were 100 pmol/L,0.91(0.83 to 0.96) ad 0.64(0.55 to 0.74),respectively.With the cardiac function classification of NYHA increasing,the level of MR-proANP increased(P<0.01),and the MR-proANP was positively correlated with NT-proBNP(r_s=0.64,P<0.01).Conclusions:MR-proANP is a useful diagnostic marker for HF in dyspnea patients.The combined detection of MR-proANP and NT-proBNP can improve the diagnostic accuracy of HF.
- heart failure /
- dyspean /
- midregion of pro-atrial natriuretic peptide

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中段心房利钠肽原对呼吸困难人群心力衰竭的诊断价值

作者简介: 杨爱龙(1977-),男,副主任技师.

北京军区总医院263临床部, 北京 101149

收稿日期: 2017-01-16

关键词:

摘要: 目的：评价中段心房利钠肽原（MR-proANP）对呼吸困难人群心力衰竭（心衰）的诊断价值。方法：前瞻性纳入203例因呼吸困难就诊的病人，包括96例心衰病人和107例非心衰病人。以KRYPTOR平台检测病人就诊时血浆中MR-proANP水平。采用受试者工作特征曲线法分析MR-proANP对心衰的诊断价值，同时与B型利钠肽前体N端（NT-proBNP）进行比较。采用logistic回归模型将NT-proBNP和MR-proANP合并为一个参数（NT-proBNP+MR-proANP），并分析其诊断心衰的准确性。分析纽约心脏病协会（NYHA）心功能分级、NT-proBNP水平与MR-proANP的相关性。并收集120名健康体检者的血浆，用于分析MR-proANP的参考范围。结果：心衰病人血浆MR-proANP水平明显高于非心衰病人（P<0.01）。NT-proBNP ROC曲线下面积与MR-proANP差异无统计学意义（P>0.05）。NT-proBNP和MR-proANP联合诊断心衰的ROC曲线下面积均高于MR-proANP和NT-proBNP曲线下面积（P<0.05）。MR-proANP的最佳诊断界值为100 pmol/L，对应的诊断敏感性（95%CI）和特异性（95%CI）分别为0.91（0.83~0.96）和0.64（0.55~0.74）。随着NYHA心功能分级的升高，心衰病人血浆MR-proANP水平增加（P<0.01）。MR-proANP和NT-proBNP呈正相关关系（r_s=0.64，P<0.01）。结论：MR-proANP对呼吸困难人群心衰的诊断具有一定帮助。联合MR-proANP和NT-proBNP可以提高心衰的诊断准确性。

English Abstract

Diagnostic value of MR-proANP for heart failure in dyspnea patients

The 263 Clinical Branch of the Army General Hospital, Beijing 101149, China

Received Date: 2017-01-16

Abstract: Objective:To explore the diagnostic value of midregion of pro-atrial natriuretic peptide(MR-proANP) for heart failure in dyspnea patients.Methods:The serum levels of MR-proANP in 203 dyspnea patients[including 96 heart failure(HF) patients and 107 non-HF patients] on admission was determined by KRYPTOR platform.The diagnostic value of MR-proANP for HF was analyzed using receiver operating characteristic(ROC) curve,and which was compared with amino-terminal pro-B type natriuretic peptide(NT-proBNP).The MR-proANP and NT-proBNP were combined into an index using logistic regression model,which was used to analyze its diagnostic accuracy for HF.The relationships between cardiac function of New York Heart Association(NYHA),NT-proBNP and MR-proANP were analyzed.The reference range of MR-proANP was established by 120 healthy examinees.Results:The serum level of MR-proANP in HF patients was higher than that in non-HF patients(P<0.01).The difference of the area under ROC curve between NT-proBNP and MR-proANP was not statistically significant(P>0.05).The area under ROC curve of the joint diagnosis of heart failure with NT-proBNP and MR-proANP was higher than that in MR-proANP or NT-proBNP(P<0.05).The optimal threshold,sensitivity and specificity of MR-proANP were 100 pmol/L,0.91(0.83 to 0.96) ad 0.64(0.55 to 0.74),respectively.With the cardiac function classification of NYHA increasing,the level of MR-proANP increased(P<0.01),and the MR-proANP was positively correlated with NT-proBNP(r_s=0.64,P<0.01).Conclusions:MR-proANP is a useful diagnostic marker for HF in dyspnea patients.The combined detection of MR-proANP and NT-proBNP can improve the diagnostic accuracy of HF.