Feng Shao-Dan, Jiang Yong, Lin Zhi-Hong, Lin Pei-Hong, Lin Si-Ming, Liu Qi-Cai
Department of Emergency, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China Department of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Medicine (Baltimore). 2017 Aug;96(34):e7526. doi: 10.1097/MD.0000000000007526.
This study aims to evaluate the diagnostic value of beta-endorphin (β-EP) and brain natriuretic peptid (BNP) plasma concentrations for the early diagnosis of acute left heart failure and atrial fibrillation.
A total of 45 patients were included. These patients comprised 23 male and 22 female patients,and 20 healthy subjects who underwent physical examinations in the Outpatient Department during the same periodwere included and assigned to the control group.
The diagnos stand was that of the Chinese guidelines for the diagnosis and treatment of heart failure.
Enzyme-linked immunosorbent assay was performed to detect the plasma concentration of β-EP and BNP in the treatment and control groups, and electrocardiogram targeting was performed to determine the left ventricular ejection fraction (LVEF).
BNP, β-EP, and LVEF levels were higher in the treatment group (688.01 ± 305.78 ng/L, 394.06 ± 180.97 ng/L, and 70.48 ± 16.62%) compared with the control group (33.90 ± 8.50 ng/L, 76.87 ± 57.21 ng/L, and 32.11 ± 5.25%). The P-values were .015, .019, and .026, respectively, which were <.05. The difference was statistically significant. The BNP and β-EP's 4 correlations (r = 0.895, P <.001), BNP, β-EP, and the combination of BNP and β-EP for acute left heart failure diagnosis in maximizing Youden index sensitivity, specific degree, area under the ROC curve (AUC), and 95% confidence interval (CI) were respectively 93.5%, 81.3%, 0.921, 0.841, 0.921; 80.5%, 78.6%, 0.697, 0.505, 0.697; 94.1%, 83.5%, 0.604 to 0.979, and 0.604. Acute left heart failure in patients with LVEF acuity plasma BNP and β-EP 50% group was obviously lower than that in the LVEF <50% group (P <.01). BNP, β-EP, and LVEF were negatively correlated (r = -0.741, -0.635, P = .013, .018).
β-EP and BNP have high specificity and sensitivity for detecting early acute left heart failure and atrial fibrillation in patients, which is convenient, easy to perform, and suitable for clinical applications.
本研究旨在评估β-内啡肽(β-EP)和脑钠肽(BNP)血浆浓度对急性左心衰竭和心房颤动早期诊断的价值。
共纳入45例患者。这些患者包括23例男性和22例女性患者,同时纳入20例同期在门诊接受体检的健康受试者并分配至对照组。
诊断标准依据中国心力衰竭诊断和治疗指南。
采用酶联免疫吸附测定法检测治疗组和对照组血浆β-EP和BNP浓度,并进行心电图检查以测定左心室射血分数(LVEF)。
治疗组的BNP、β-EP和LVEF水平(分别为688.01±305.78 ng/L、394.06±180.97 ng/L和70.48±16.62%)高于对照组(分别为33.90±8.50 ng/L、76.87±57.21 ng/L和32.11±5.25%)。P值分别为0.015、0.019和0.026,均<0.05。差异具有统计学意义。BNP和β-EP的4项相关性(r = 0.895,P<0.001),BNP、β-EP以及BNP与β-EP联合用于急性左心衰竭诊断时,在最大化约登指数的敏感度、特异度、ROC曲线下面积(AUC)和95%置信区间(CI)方面分别为93.5%、81.3%、0.921、0.841、0.921;80.5%、78.6%、0.****、0.505、0.697;94.1%、83.5%、0.604至0.979以及0.604。急性左心衰竭患者中LVEF≥50%组的血浆BNP和β-EP明显低于LVEF<50%组(P<0.01)。BNP、β-EP与LVEF呈负相关(r = -0.741、-0.635,P = 0.013、0.018)。
β-EP和BNP对检测患者早期急性左心衰竭和心房颤动具有较高的特异性和敏感性,操作方便、易行,适用于临床应用。