【摘要】 目的评价氨基端前脑钠肽(NT-proBNP)在诊断老年人左心室功能不全(LVD)的价值。方法用电化学发光免疫学方法(Elecsys,罗氏诊断)检测102例LVD老人和98名健康老人(对照组)血NT-proBNP,分析各种临床因素与NT-proBNP之间的关系。结果正常对照组NT-proBNP(中位数)为53.25pg/mL,与左心室射血分数(LVEF)、血肌酐的关系密切,和年龄、性别无关。LVD老人NT-proBNP随着心功能分级(纽约心脏学会NYHA)的增加而升高。NT-proBNP还同LVEF呈良好的负相关(r=-0.735,P<0.001),不同LVEF的各组LVD患者间NT-proBNP水平有显著差异(P<0.001)。多因素线性回归分析发现,NYHA心功能分级和LVEF的存在对NT-proBNP有影响。NT-proBNP探测老年人LVD的受试者工作特性曲线下面积(AUC)为0.97,界值117.6pg/mL的灵敏度91.1%,特异度95.9%。结论NT-proBNP水平是确定老年人LVD的良好指标,与心力衰竭的严重程度以及左心室功能密切相关。更多还原

【Abstract】 Purpose Aminoterminal portion of pro-brain natriuretic peptide(NT-proBNP) appears to be useful in the screening,diagnosis and prognosis of left ventricular dysfunction(LVD) and congestive heart failure.The purpose of this study was to determine the values of serum NT-proBNP in Shanghai elderly patients with LVD. Methods We measured serum NT-proBNP in 102 elderly patients with LVD(87 males) and 98 healthy elderly(71 males) as the control.The NT-proBNP was measured by using Elecsys 2010(Roche Diagnostics,Switzerland). Results The concentrations of NT-proBNP(median) in control subjects were 53.25 pg/mL and multi-factors linear regression analysis showed that left ventricular ejection fraction(LVEF) and creatinine might correlate to NT-proBNP excluding other factors.There were no difference of age and sex.In 102 elderly patients with LVD,NT-proBNP level elevated with New York Heart Association(NYHA) classification increased.The difference was significant(P<0.001).NT-proBNP level showed a negative correlation with LVEF((r=-0.735,) P< 0.001).Multi-factors linear regression analysis showed that NYHA classification and LVEF might correlate to NT-proBNP excluding sex,age and clinic history.The area under the receiver operator characteristic curve(AUC) were 0.97 and the cut-off level was determined as 117.6 pg/mL for NT-proBNP giving a sensitivity of 91.1% and specificity of(95.9%.) Conclusions The NT-proBNP level is a sensitive indicator of LVD also in elderly patients and may trigger further cardiac investigation.更多还原