NT-proBNP在心力衰竭中的诊断意义及预后价值探讨(1)
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摘要：目的：探讨NT-proBNP在心力衰竭中的诊断意义及预后价值。方法：选取60例心衰患者为观察组与同期健康体检者60例设为对照组，测定血浆中的NT-ProBNP、超声测定左室射血分数(LVEF)，左室舒张末内径(LVDd)及评价NYHA心功能分级。结果：①观察组的NYHAⅡ、Ⅲ、Ⅳ级与对照组的血浆enNT-proBNP水平两两比较有统计学差异(P<0.01)，心功能越差血浆enNT-proBNP水平显著升高。②enNT-proBNP(取自然对数en)与LVDd呈正相(r=0.424，P<0.01)，nNT-proBNP与LVEF呈负相关(r=-0.408，P<0.01)。③ NT-proBNP诊断心衰的ROC 曲线显示，当cut-Off值定为459pg/ml时，正确诊断指数最高(0.579)，此时敏感度76.8%，特异度100%。④心衰患者出院时NT-proBNP升高组35例，正常组25例。升高组3个月内因心衰再住院者14例(40.0%)，正常组3例(12.0%)，两组之间的差异有显著性(P<0.001)。结论：NT-proBNP是诊断心衰的可靠指标，与心衰的严重程度密切相关，动态观察NT-proBNP变化水平可有效地判断心衰患者的预后。
关键词：心力衰竭 NT-proBNP 诊断 预后价值
NT-proBNP in diagnosis of heart failure and prognosis value of
Xu Huixian
Abstract:Objective:Investigate the significance of NT-proBNP in diagnosis of heart failure and its prognostic value.Methods：60 cases of heart failure patients selected for observation group with the same period in 60 healthy persons were selected as control group,the determination of plasma NT-ProBNP,ultrasound determination of left ventricular ejection fraction ( LVEF ),left ventricular end diastolic diameter ( LVDd NYHA ) and evaluation of cardiac function classification.Results：The observation group,Ⅲ NYHA Ⅱ,Ⅳ and controls the plasma level of enNT-proBNP two two compared with statistical difference (P < 0.01 ),heart function and the plasma enNT-proBNP level was significantly elevated.The enNT-proBNP ( log EN ) and LVDd was positive ( r = 0.424,P < 0.01 ),nNT-proBNP negatively correlated with LVEF ( r = - 0.408,P < 0.01 ).The diagnosis of heart failure and NT-proBNP ROC curve display,when the value of cut-Off is 459pg / ml,correct diagnosis index is the highest (0 ......
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