NT-proBNP和BNP检测在心脏护理中的应用：一种用于心力衰竭检测和评估的更具辨别力的标志物。

Application of NT-proBNP and BNP measurements in cardiac care: a more discerning marker for the detection and evaluation of heart failure.

作者信息

Seino Yoshihiko, Ogawa Akio, Yamashita Teruyo, Fukushima Masato, Ogata Ken-ichi, Fukumoto Hiroko, Takano Teruo

机构信息

The First Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Tokyo, Japan.

出版信息

Eur J Heart Fail. 2004 Mar 15;6(3):295-300. doi: 10.1016/j.ejheart.2003.12.009.

DOI:10.1016/j.ejheart.2003.12.009

PMID:14987579

Abstract

BACKGROUND

Measurement of brain natriuretic peptide (BNP) has become a potent diagnostic aid as a means of identifying patients with systolic or diastolic dysfunction. Due to better stability in circulating blood, we reasoned that measurement of N-terminal proBNP (NT-proBNP) may be a more discerning marker for the detection and evaluation of chronic heart failure.

METHODS

The relationships between plasma concentrations of NT-proBNP and BNP, and aetiology, New York Heart Association (NYHA) classification, and left ventricular ejection fraction (LVEF) were analyzed in 105 patients with chronic heart failure. Sixty-seven healthy volunteers were studied as the controls.

RESULTS

Both NT-proBNP and BNP showed progressive increases (P<0.001) in proportion to the NYHA classification; the increment of NT-proBNP was larger than that of BNP. Elevated NT-proBNP significantly correlated with BNP (r=0.737, P<0.001). Receiver operating characteristics analysis to detect LVEF<40% showed similar values (area under the curve, AUC: NT-proBNP 0.754 vs. BNP 0.770), however, AUC to detect LVEF<50% tended to be greater for NT-proBNP than that for BNP (NT-proBNP 0.820 vs. BNP 0.794).

CONCLUSION

NT-proBNP may be a more discerning marker for the detection and evaluation of heart failure than BNP.

摘要

背景

脑钠肽（BNP）检测已成为一种有效的诊断辅助手段，用于识别收缩或舒张功能障碍患者。鉴于其在循环血液中具有更好的稳定性，我们推断N末端脑钠肽前体（NT-proBNP）检测可能是检测和评估慢性心力衰竭更具鉴别力的标志物。

方法

分析了105例慢性心力衰竭患者血浆NT-proBNP和BNP浓度与病因、纽约心脏协会（NYHA）分级及左心室射血分数（LVEF）之间的关系。选取67名健康志愿者作为对照进行研究。

结果

NT-proBNP和BNP均随NYHA分级呈逐渐升高趋势（P<0.001）；NT-proBNP的升高幅度大于BNP。NT-proBNP升高与BNP显著相关（r=0.737，P<0.001）。检测LVEF<40%的受试者工作特征分析显示二者曲线下面积（AUC）值相近（NT-proBNP为0.754，BNP为0.770），然而，检测LVEF<50%时，NT-proBNP的AUC往往大于BNP（NT-proBNP为0.820，BNP为0.794）。