外周血和胸腔积液NT-proBNP对心力衰竭的诊断价值
| 作者: |
1张忠印,
2颜永进,
1吉飞跃,
3顾兵
1 南通大学附属海安医院检验科，江苏 南通 226600 2 南通大学附属海安医院心内科，江苏 南通 226600 3 徐州医学院附属医院检验科，江苏 徐州 22 1006 |
| 通讯: |
张忠印
Email: 18921621668@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2015.09.008 |
摘要
目的：评价外周血和胸腔积液中N末端B型利钠肽(NT-proBNP)在胸腔积液患者中诊断心力衰竭的价值。方法：检测59例心力衰竭患者、11例结核性胸腔积液患者、31例肺炎性胸腔积液患者和36 例恶性肿瘤性胸腔积液患者外周血和胸腔积液中的NT-proBNP水平，采用受试者工作特征曲线法(ROC)评价了外周血和胸腔积液中NT-proBNP对心力衰竭的诊断价值，分析了外周血和胸腔积液中NT-proBNP的相关性以及二者与患者纽约心脏病学会心功能分级(New York Heart Association， NYHA)的关系。结果：心衰患者外周血和胸腔积液中的NT-proBNP水平较非心衰患者明显增高。外周血和胸腔积液中NT-proBNP诊断心衰的曲线下面积分别为0.94和0.93。胸腔积液和外周血NT-proBNP确诊心衰的最佳界值是2 800 pg/mL，排除心衰的最佳界值为900 pg/mL。胸腔积液和外周血NT-proBNP呈正相关，相关系数为0.91。胸腔积液和外周血中NT-proBNP均随着NYHA分级的递进而增加。结论：胸腔积液和外周血中NT-proBNP是诊断心衰的有益标志物。
关键词：
胸腔积液
心衰
NT-proBNP
诊断
Diagnostic value of NT-proBNP in blood and pleural fluid for patients with heart failure
CorrespondingAuthor: ZHANG Zhongyin Email: 18921621668@163.com
DOI: 10.3978/j.issn.2095-6959.2015.09.008
Abstract
Objective: The aim of this study was to evaluate the diagnostic value of blood and pleural fluid (PF) NT-proBNP for patients with heart failure (HF). Methods: Blood and PF NT-proBNP levels in 59 patients with HF, 11 patients with tuberculosis, 31 patients with parapneumonic effusion and 36 patients with malignancy were measured. The diagnostic value of blood and PF NT-proBNP for HF was evaluated by a receiver operating characteristic (ROC) curve analysis. The relationship between blood and PF NT-proBNP, as well as The New York Heart Association (NYHA) functional classification system, was analyzed. Results: Both blood and PF NT-proBNP were significantly increased in HF patients. The area under ROC curve (AUC) for blood and PF NT-proBNP were 0.94 and 0.93, respectively. The optimal threshold used for ruling in and ruling out HF were 2 800 and 900 pg/mL. Blood and PF NT-proBNP were positively correlated, with a coefficient of 0.91, respectively. Both blood and PF NT-proBNP were increased with the advance of NYHA functional classification system. Conclusion: Both blood and PF NT-proBNP are useful diagnostic marker for HF in patients with PF.