【摘要】 目的 探讨血清甲状旁腺激素（PTH）联合N端B型-脑利纳肽前体（NT-pro BNP）检测在老年急性心力衰竭（AHF）患者中的诊断价值。方法 选取2021年10月至2022年10月山东大学齐鲁医院接诊的115例老年AHF患者作为研究组，并根据其严重程度分为轻度组（n=31）、中度组（n=56）、重度组（n=28），另外选取同期行健康体检的110名正常老年人作为参照组。采集空腹静脉血并测定所有受试者的PTH、NT-pro BNP，比较两组受试者的PTH、NT-pro BNP水平及不同程度AHF患者的PTH、NT-pro BNP水平，并分析PTH、NT-pro BNP单独和联合检测诊断老年AHF的效能。结果 研究组患者的PTH、NT-pro BNP水平均高于参照组，差异有统计学意义（P<0.05）。不同病情程度的老年AHF患者血清PTH、NT-pro BNP水平比较，差异有统计学意义（P<0.05），其中重度组的PTH、NT-pro BNP高于中度组和轻度组，中度组的PTH、NT-pro BNP高于轻度组，差异有统计学意义（P<0.05）。三种检测方法诊断老年AHF的灵敏度、阴性预测值及准确性比较，差异有统计学意义（P<0.05）；联合检测诊断老年AHF的灵敏度和阴性预测值高于PTH、NT-pro BNP单独检测，准确性高于PTH单独检测，差异有统计学意义（P<0.017）。结论 血清PTH联合NT-pro BNP检测进行老年AHF诊断能提高诊断的准确性，还能在一定程度为病情严重程度的评估分级提供参考依据。更多还原

【Abstract】 Objective To investigate the value of serum parathyroid hormone(PTH) combined with N-terminal B-brain lineptide precursor(NT-pro BNP) in the diagnosis of elderly patients with acute heart failure(AHF). Methods A total of 115elderly patients with AHF admitted to Qilu Hospital of Shandong University from October 2021 to October 2022 were selected as the study group, and divided into mild group(n=31), moderate group(n=56) and severe group(n=28) according to their severity. In addition, 110 normal elderly patients who underwent physical examination during the same period were selected as the reference group. Fasting venous blood was collected and PTH and NT-pro BNP levels of all subjects were measured, PTH and NT-pro BNP levels of subjects in the two groups were compared and PTH and NT-pro BNP levels of patients with different degrees of AHF were compared, and the efficacy of PTH and NT-pro BNP alone and combined detection in the diagnosis of elderly AHF was analyzed. Results The levels of PTH and NT-pro BNP in the study group were higher than those in the reference group, and the differences were statistically significant(P<0.05). The serum PTH and NT-pro BNP levels of elderly AHF patients with different disease degrees were compared, and the difference was statistically significant(P<0.05). The PTH and NT-pro BNP levels in the severe group were higher than those in the moderate group and the mild group, and the PTH and NT-pro BNP levels in the moderate group were higher than those in the mild group, and the differences were statistically significant(P<0.05). The sensitivity, negative predictive value and accuracy of the three methods in the diagnosis of AHF in the elderly were compared, and the differences were statistically significant(P<0.05). The sensitivity and negative predictive value of combined detection in the diagnosis of elderly AHF were higher than that of PTH and NT-pro BNP alone detection, and the accuracy was higher than that of PTH alone detection, the differences were statistically significant(P<0.017). Conclusion The combination of serum PTH with NT-pro BNP to diagnose elderly AHF can improve the accuracy of diagnosis and provide reference for the assessment of disease severity to a certain extent.更多还原