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N末端脑钠肽前体与心房钠尿肽在慢性充血性心力衰竭诊断及预后评估中的价值比较研究

[Comparison study on diagnostic and prognostic value of N-terminal probrain natriuretic peptide and atrium natriuretic peptide in chronic congestive heart failure].

作者信息

Dong Hui, Chen Da-qiang, Wang Yan, Li Ming

机构信息

Department of Clinical Laboratory, People's Hospital of Guangdong Province, Guangzhou, China.

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2008 Aug;28(9):1740-2.

PMID:18819908
Abstract

OBJECTIVE

To investigate the diagnostic and prognostic value of N-terminal probrain natriuretic peptide(NT-proBNP)and atrium natriuretic peptide(ANP)in chronic congestive heart failure.

METHODS

One hundred and eighteen coronary heart disease patients were enrolled in the study. Among them 78 patients were accompanied by heart failure and 40 with no heart failure. Plasma NT-proBNP was determined with Elecsys Chemiluminescence Immunoassay method, and plasma ANP was determined with radioimmunoassay method.The results were compared with those of 40 healthy individuals. All patients were followed up accordingly.

RESULTS

Compared with patients with no heart failure and healthy individuals, the patients with heart failure had a higher plasma NT-proBNP and ANP contents(P<0.05). Cardiac function grade IV patients had a significantly higher plasma NT-proBNP than cardiac function grade II and III patients, and their plasma ANP level was significanthy higher than that of cardiac function grade III patients, but there was no significantly difference in ANP content between cardiac function grade IV and II.The diagnostic sensitivity of NT-proBNP and ANP was 91.25% and 73.46%, respectively. The diagnostic specificity of NT-proBNP and ANP was 90.25%, 80.33%, respectively. In the heart failure group, it was found that there was no significant difference in the plasma NT-proBNP and ANP between the deaths and surviving patients.

CONCLUSION

The diagnostic value of NT-proBNP in chronic heart failure is higher than that of ANP. According to our follow- up result, the plasma NT-proBNP and ANP can not be relied up on to predict short -term cardiogenic death in heart failure.

摘要

目的

探讨N末端脑钠肽原(NT-proBNP)和心房钠尿肽(ANP)在慢性充血性心力衰竭中的诊断及预后价值。

方法

选取118例冠心病患者,其中78例合并心力衰竭,40例未合并心力衰竭。采用电化学发光免疫分析法测定血浆NT-proBNP,采用放射免疫分析法测定血浆ANP。将结果与40例健康个体进行比较。所有患者均进行相应随访。

结果

与未合并心力衰竭患者及健康个体相比,心力衰竭患者血浆NT-proBNP和ANP含量更高(P<0.05)。心功能Ⅳ级患者血浆NT-proBNP显著高于心功能Ⅱ级和Ⅲ级患者,其血浆ANP水平显著高于心功能Ⅲ级患者,但心功能Ⅳ级与Ⅱ级患者的ANP含量无显著差异。NT-proBNP和ANP的诊断敏感性分别为91.25%和73.46%。NT-proBNP和ANP的诊断特异性分别为90.25%、80.33%。在心力衰竭组中,死亡患者与存活患者的血浆NT-proBNP和ANP无显著差异。

结论

NT-proBNP在慢性心力衰竭中的诊断价值高于ANP。根据我们的随访结果,血浆NT-proBNP和ANP不能用于预测心力衰竭患者的短期心源性死亡。

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