检验医学 ›› 2013, Vol. 28 ›› Issue (1): 30-32.DOI: 10.3969/j.issn.1673-8640.2013.01.007

• 临床应用研究.论著 • 上一篇    下一篇

NT-proBNP和cTnI联合检测在急诊心力衰竭患者诊治中的应用

朱笑频1,王成刚2   

  1. 义乌市中心医院检验科,浙江 义乌 322000
  • 收稿日期:2012-05-07 修回日期:2012-05-18 出版日期:2013-01-30 发布日期:2013-01-10
  • 通讯作者: 王成刚,联系电话:0579-85209689。
  • 作者简介:朱笑频,女,1972年生,主管技师,主要从事临床免疫学检验工作。

The application of combined detection of the NT-proBNP and cTnI in the diagnosis and treatment of acute heart failure patients

  1. Department of Clinical Laboratory,the Central Hospital of Yiwu,Zhejiang Yiwu 322000,China
  • Received:2012-05-07 Revised:2012-05-18 Online:2013-01-30 Published:2013-01-10

摘要: 目的 探讨联合检测氨基末端B型钠尿肽原(NT-proBNP)和心肌肌钙蛋白I(cTnI)水平在急诊心力衰竭(HF)患者诊治中的应用。 方法 采用酶联免疫荧光法检测急诊室送检的708例心血管疾病患者(HF 195例、非HF 513例)血浆NT-proBNP和cTnI水平。将HF患者按美国心脏病协会纽约心脏学会(NYHA)心功能分级标准分为Ⅰ~Ⅳ级。检测结果采用中位数(四分位数)表示,采用秩和检验进行统计分析。 结果 HF组血浆NT-proBNP和cTnI分别为3 718(1 035~12 258)ng/L、7.18(2.05~14.16)μg/L,明显高于非HF组[NT-proBNP为145(30~585)ng/L、cTnI为0.66(0.06~1.99)μg/L,P<0.01]。NYHA Ⅱ、Ⅲ、Ⅳ级HF患者之间民NT-proBNP、cTnI水平差异有统计学意义(P<0.05)。联合检测NT-proBNP和cTnI的敏感性和特异性分别为99%和90%,远高于单项检测(P<0.05)。 结论 对于急诊室送检的疑似HF的心血管疾病患者血标本,及时进行NT-proBNP和cTnI水平的联合检测在HF的诊治中十分有价值。

关键词: 氨基末端B型钠尿肽原, 心肌肌钙蛋白I, 心力衰竭

Abstract: Objective To investigate the application of combined detection of the N-terminal pro-B-type natriuretic peptide(NT-proBNP)and cardiac troponin I(cTnI)in the diagnosis and treatment of acute heart failure(HF)patients in emergency department.   Methods Enzyme-linked immunosorbent fluorescence assay was used to determine plasma NT-proBNP and cTnI levels in 708 patients with cardiovascular diseases(195 patients with HF and 513 patients with non-HF). Acoording to the New York Heart Assoeiation(NYHA)cardiac function grades,the HF patients were chassified into Grade Ⅰ-Ⅳ. The results were expressed by medians(quartiles). The results were analyzed statistically. Results The levels of NT-proBNP and cTnI in HF group were 3 718(1 035-12 258)ng/L and 7.18(2.05-14.16)μg/L,respectively,which were significantly higher than those in [145(30-585)ng/L for NT-proBNP and 0.66(0.06-1.99)μg/L for cTnI,P<0.01]. Statistical significance was also observed when comparing NT-proBNP and cTnI levels of the patients with HF at NYHA Grade Ⅱ,Ⅲ and Ⅳ (P<0.05). Furthermore,the sensitivity(99%)and specificity(90%)for the diagnosis of HF with the combined detection of NT-proBNP and cTnI were much higher than those with either the detection of NT-proBNP or cTnI alone(P<0.05). Conclusions The combined detection of NT-proBNP and cTnI has valuable significance in the diagnosis and treatment of HF in emergency department.

Key words: N-terminal pro-brain natriuretic peptides, Cardiac troponin I, Cardiac Failure