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目的对比脑钠肽(BNP)与N端前体脑钠肽(NT-ProBNP)对于心功能不全患者的诊断价值及血肌酐水平对于BNP与NT-ProBNP的影响。方法 54例心功能不全患者按NYHA分级,Ⅰ级组9例,Ⅱ级组16例,Ⅲ级组15例,Ⅳ级组14例,分别检测其BNP与NT-ProBNP,并根据其肌酐是否>104μmol/L分为肾功能正常组与肾功能不全组。比较NYHA分级与BNP、NT-ProBNP、EF、6min步行试验关系及相关性。利用ROC(receiver operating characteristic,ROC)曲线比较BNP、NT-ProBNP对于心功能不全的诊断价值。结果①不同NYHA心功能分级患者的血浆BNP、NT-ProBNP水平不同,随心功能分级的增加而增高(P<0.05)。②血浆BNP、NT-ProBNP水平与EF、6min步行试验呈负相关(P<0.05)。③肾功能正常组与肾功能不全组其BNP水平分布差异无统计学意义,而NT-proBNP水平分布差异具有统计学意义。结论在肾功能正常的患者,由于NT-proBNP稳定,半衰期长,可为评价心功能的很好指标。但对于肾功能不全患者,BNP是较NT-proBNP更能反映心功能的指标。
Objective To compare the diagnostic value of brain natriuretic peptide (BNP) and N-terminal pro brain natriuretic peptide (NT-ProBNP) in patients with cardiac insufficiency and the effect of serum creatinine on BNP and NT-ProBNP. Methods Fifty-four patients with cardiac dysfunction were divided into NYHA class, 9 cases in grade Ⅰ group, 16 cases in grade Ⅱ group, 15 cases in grade Ⅲ group and 14 cases in grade Ⅳ group. BNP and NT-ProBNP were detected respectively according to their creatinine> 104μmol / L divided into normal renal function group and renal insufficiency group. NYHA classification and BNP, NT-ProBNP, EF, 6min walk test and correlation. The receiver operating characteristic (ROC) curve was used to compare the diagnostic value of BNP and NT-ProBNP in patients with cardiac insufficiency. Results ① The levels of plasma BNP and NT-ProBNP were different in patients with NYHA classifications, and increased with the increase of cardiac function grade (P <0.05). ② Plasma BNP and NT-ProBNP levels were negatively correlated with EF, 6-minute walking test (P <0.05). ③ There was no significant difference in the distribution of BNP between normal renal function group and renal dysfunction group, but the difference of NT-proBNP level had statistical significance. Conclusions In patients with normal renal function, NT-proBNP is a good indicator of cardiac function because of its stable half-life. However, in patients with renal insufficiency, BNP is more indicative of cardiac function than NT-proBNP.