上海交通大学学报（医学版）

›› 2009, Vol. 29 ›› Issue (10): 1226-.

• 论著（临床研究） • 上一篇    下一篇

脑钠肽和N端脑钠肽前体在老年心力衰竭患者诊断中的价值

蔡 秦, 金玉华, 方宁远   

  1. 上海交通大学 医学院仁济医院老年病科, 上海 200001
  • 出版日期:2009-10-25 发布日期:2009-10-26
  • 通讯作者: 金玉华, 电子信箱: doctorjyh@163.com。
  • 作者简介:蔡 秦（1982—）, 女, 住院医师, 硕士生；电子信箱: may.caiqin@gmail.com。

Value of brain natriuretic peptide and N-terminal pro-brain natriuretic peptide in diagnosis of heart failure in the elderly

CAI Qin, JIN Yu-hua, FANG Ning-yuan   

  1. Department of Geriatrics, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China
  • Online:2009-10-25 Published:2009-10-26

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摘要：

目的 探讨老年心力衰竭患者血浆脑钠肽（BNP）及N端脑钠肽前体（NT-proBNP）与纽约心脏病协会（NYHA）分级、左室结构及功能的关系，评价其在老年心力衰竭患者诊断中的临床价值。方法 选取老年心力衰竭患者55例（NYHA Ⅱ 15例，Ⅲ级25例，Ⅳ级15例），老年NYHA Ⅰ级者16例设为对照组。采用电化学发光双抗体夹心法测定血浆NT-proBNP的质量浓度；免疫荧光快速测试法测定血浆BNP的质量浓度；心脏彩色多普勒超声测定左室结构和功能。结果 心力衰竭组和对照组患者的血浆NT-proBNP和BNP值均随NYHA心功能分级的递增而逐级升高（P<0.001）。所有患者的BNP和NT-proBNP质量浓度与LVEF呈负相关（P<0.001），与LVMI、LVST、LVEDD、LAD呈正相关（P<0.05）。血浆BNP浓度诊断老年心力衰竭患者的ROC曲线下面积为0.879（P<0.001）；血浆NT-proBNP的ROC曲线下面积为0.914（P<0.001）。结论 血浆NT-proBNP和BNP均能较好地反映老年心力衰竭患者的心功能状态，对于病情评估具有一定的临床价值。

关键词: 老年人, 心力衰竭, 脑钠肽, N端脑钠肽前体

Abstract:

Objective To investigate the relationship between brain natriuretic peptide(BNP)/N-terminal pro-brain natriuretic peptide (NT-proBNP) and New York Heart Association (NYHA) classification, left ventricular structure and function, and explore the value of BNP/NT-proBNP in the diagnosis of heart failure in the elderly. Methods Fifty-five elder patients with heart failure were selected (NYHA Ⅱ, n=15; NYHA Ⅲ, n=25; NYHA IV, n=15) (heart failure group), and another 16 elder people with NYHA I were served as control group.The plasma mass concentrations of NT-proBNP and BNP were detected by electrochemiluminescence immunoassay and immunofluorescence method, respectively, and the structure and function of left ventricle were examined by echocardiography. Results The levels of plasma BNP and NT-proBNP increased with NYHA grades, were negatively correlated with LVEF (P<0.001), and were positively correlated with LVST, LVEDD, LAD and LVMI(P<0.05). The area under the curve of BNP in diagnosis of heat failure was 0.879 (P<0.001), and that of NT-proBNP was 0.914（P<0.001）. Conclusion Both plasma BNP and NT-proBNP can be used to evaluate the heart function of patients with heart failure, and are useful tools for diagnosis of HF in the elderly.

Key words: the elderly, heart failure, brain natriuretic peptide, N-terminal pro-brain natriuretic peptide

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