【摘要】 目的 探讨脑钠肽(BNP)、肌钙蛋白I(cTnI)联合超声心功能参数检测对慢性心力衰竭心功能分级的评估价值。方法 将2016年3月—2020年9月本院收治的139例慢性心力衰竭作为观察组(据美国纽约心脏病协会心功能分级标准又分为Ⅰ级亚组33例、Ⅱ级亚组39例、Ⅲ级亚组34例、Ⅳ级亚组33例),同时选取本院体检健康者142例作为对照组。比较观察组、对照组及观察组各亚组间BNP、cTnI及超声心功能参数，并绘制受试者工作特征(ROC)曲线分析BNP、cTnI、超声心功能参数联合检测对慢性心力衰竭患者心功能分级的评估价值。结果 观察组BNP、cTnI、左室舒张末期内径(LVEDD)、每搏量(SV)明显高于对照组，左心室射血分数(LVEF)、左心室短轴缩短率(FS)明显低于对照组(P<0.01)。BNP、cTnI水平Ⅰ级亚组<Ⅱ级亚组<Ⅲ级亚组<Ⅳ级亚组，LVEDD、SV水平Ⅰ级亚组<Ⅱ级亚组<Ⅲ级亚组<Ⅳ级亚组，LVEF、FS水平Ⅰ级亚组>Ⅱ级亚组>Ⅲ级亚组>Ⅳ级亚组(P<0.05)。ROC曲线分析显示，BNP、cTnI、超声心功能参数联合检测评估慢性心力衰竭患者心功能分级的敏感度(93.78%)、特异度(94.22%)、曲线下面积(0.955)均显著高于单一检测。结论 临床可通过BNP、cTnI、超声心功能参数联合检测提高慢性心力衰竭患者心功能分级评估的准确性，为制定合理的治疗方案提供参考。更多还原

【Abstract】 Objective To evaluate the value of brain natriuretic peptide(BNP) and troponinI(cTnI) combined with echocardiographic parameters in the evaluation of cardiac function classification in patients with chronic heart failure(CHF). Methods In total, 139 cases of CHF admitted to our hospital from March 2016 to September 2020 were selected as the observation group [divided into grade I subgroup(n=33), grade Ⅱ subgroup(n=39), grade Ⅲ subgroup(n=34), and grade Ⅳ subgroup(n=33) according to the heart function classification standard of New York Heart Association], and 142 healthy physical examinees in our hospital were selected as the control group. BNP, cTnI and echocardiographic parameters were compared among observation group, control group and subgroups, and receiver operating characteristic(ROC) curve was drawn to analyze the predictive value of combined detection of BNP, cTnI and echocardiographic parameters for the classification of cardiac function in patients with CHF. Results BNP, cTnI, left ventricular end-diastolic diameter(LVEDD) and stroke volume(SV) in the observation group were significantly higher than those in the control group, while left ventricular ejection fraction(LVEF) and left ventricular short axis shortening rate(FS) were significantly lower than those in the control group(P<0.01). BNP and cTnI level were the lowest in grade I subgroup, followed by grade Ⅱ subgroup, grade Ⅲ subgroup and grade Ⅳ subgroup, LVEDD and SV level were the lowest in grade I subgroup, followed by gradeⅡ subgroup, grade Ⅲ subgroup, and grade Ⅳ subgroup, and LVEF and FS level were the highest in grade I subgroup, followed by gradeⅡ subgroup, grade Ⅲ subgroup and grade Ⅳ subgroup(P<0.05). ROC analysis showed that the sensitivity(93.78%), specificity(94.22%) and area under ROC curve(0.955) of combined detection of BNP, cTnI and echocardiographic parameters were significantly higher than those of single detection in predicting cardiac function classification of patients with CHF. Conclusion Combined detection of BNP, cTnI and echocardiographic parameters can improve the accuracy of evaluation of cardiac function classification in patients with CHF, and provide reference for the formulation of reasonable treatment plan.更多还原