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目的:评价N末端B型利钠肽原(NT-proBNP)对单纯主动脉瓣关闭不全(AR)心力衰竭患者的诊断价值。方法:使用酶联免疫的方法对27例单纯AR心力衰竭患者(单纯AR心力衰竭组)和76例正常对照者(正常对照组)行NT-proBNP测定,评价其对单纯AR心力衰竭的诊断价值。结果:与正常对照组相比,单纯AR心力衰竭组的NT-proBNP水平显著升高(P<0.05),差异有统计学意义;纽约心功能分级(NYHA)Ⅰ、Ⅱ级者差异无统计学意义;NYHAⅢ级者显著升高5.2倍,也显著高于NYHAⅠ、Ⅱ级者,差异均有统计学意义。在左心室舒张期末内径(LVEDD)>60 mm者显著高于LVEDD≤60 mm者(P<0.05),在合并心房颤动者也显著高于窦性心律者(P<0.01),差异均有统计学意义。当NT-proBNP阈值在1 340 pg/ml时,是诊断单纯AR心力衰竭(受试者工作特性曲线下面积=0.699,P<0.01)的最佳阈值;诊断的敏感性、特异性和准确性分别为59.26%、96.05%和86.41%。单因素分析,Log(NT-proBNP)仅与心功能(P=0.002)和LVEDD(P=0.033)呈显著正相关;多元逐步回归分析只有心功能与NT-proBNP呈独立相关。结论:NT-proBNP对单纯AR心力衰竭患者有重要诊断价值。诊断单纯AR心力衰竭的最佳阈值为1 340 pg/ml,准确性高达86.41%。
Objective: To evaluate the diagnostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with simple aortic regurgitation (AR) heart failure. Methods: NT-proBNP was measured in 27 AR patients with heart failure (AR group) and 76 healthy controls (normal control group) by enzyme-linked immunosorbent assay (ELISA) to evaluate the diagnostic value of NT-proBNP . Results: Compared with the normal control group, NT-proBNP level was significantly increased in the AR-treated group (P <0.05), and the difference was statistically significant. There was no significant difference in New York Heart Association (NYHA) Ⅰ and Ⅱ Significance; NYHA Ⅲ grade was significantly increased 5.2 times, also significantly higher than NYHA Ⅰ, Ⅱ grade, the differences were statistically significant. LVEDD> 60 mm was significantly higher than those with LVEDD ≤ 60 mm (P <0.05), and was significantly higher in patients with atrial fibrillation than in sinus rhythm (P <0.01), with statistical differences Significance of learning. The optimal threshold for diagnosis of AR heart failure alone (area under receiver operating characteristic curve = 0.699, P <0.01) at NT-proBNP threshold of 1 340 pg / ml; diagnostic sensitivity, specificity and accuracy Respectively 59.26%, 96.05% and 86.41%. In univariate analysis, Log (NT-proBNP) was positively correlated only with cardiac function (P = 0.002) and LVEDD (P = 0.033). Only multivariate stepwise regression analysis showed that cardiac function was independently associated with NT-proBNP. Conclusion: NT-proBNP has important diagnostic value in patients with heart failure of AR alone. The best threshold for diagnosing AR heart failure was 1 340 pg / ml, with an accuracy of 86.41%.