摘要
目的探讨血清B型钠尿肽(BNP)、高敏C反应蛋白(hs-CRP)、心肌肌钙蛋白I(cTnI)及尿酸(UA)联合检测在心力衰竭(HF)诊断中的临床价值。方法检测292例明确诊断为HF的不同病因、不同心功能分级[按美国纽约心脏病学会(NYHA)标准分为Ⅰ～Ⅳ级]患者以及100名健康对照者的血清BNP、hs-CRP、cTnI及UA水平。采用受试者工作特征(ROC)曲线评价各指标的敏感性和特异性,并分析4项指标联合检测的诊断价值。结果血清BNP、hs-CRP、cTnI及UA水平在HF不同心功能分级之间差异有统计学意义(P<0.05),且心功能越差,其水平越高;NYHAⅠ级的HF患者与对照组比较,BNP、hs-CRP水平差异有统计学意义(P<0.05),cTnI、UA水平差异无统计学意义(P>0.05)。HF患者4项指标联合检测对早期HF的敏感性为90.1%,明显高于单项检测(P<0.01)。结论联合检测血清BNP、hs-CRP、cTnI及UA可为HF早期诊断提供参考依据,具有重要临床价值。
Objective To investigate the clinical significance on the combined detection of B-type natriuretic peptide（BNP）,high sensitive C reactive protein（hs-CRP）,cardiac troponin I（cTnI）and uric acid（UA） in the diagnosis of heart failure（HF）.Methods The serum levels of BNP,hs-CRP,cTnI and UA in 292 patients with different etiological factors and grades of HF[according to the cardiac function standard of New York Heart Association（NYHA） Ⅰ-Ⅳ] and 100 healthy controls were determined.The sensitivity and specificity of 4 parameters were evaluated by receiver operating characteristic（ROC） curve.Results The levels of BNP,hs-CRP,cTnI and UA in different grades of HF had statistical significance（P〈0.05）.In addition,the grade was worse,and its concentration was higher.The levels of BNP and hs-CRP showed statistical significance between HF NYHA I grade patients and healthy controls（P〈0.05）,and the levels of cTnI and UA had no statistical significance between the healthy controls and HF NYHAⅠ grade patients（P〉0.05）.The sensitivity of combined detection was 90.1% in early HF diagnosis,which was higher significantly than that of the individual detection（P〈0.01）.Conclusions The significant clinical significance on the combined detection of the serum BNP,hs-CRP,cTnI and UA provides reference support in the diagnosis of early HF.
出处
《检验医学》
CAS
2012年第8期647-650,共4页
Laboratory Medicine
关键词
B型钠尿肽
高敏C反应蛋白
心肌肌钙蛋白Ⅰ
尿酸
心力衰竭
-type natriuretic peptide； High sensitive C reactive protein； Cardiac troponin I； Uric acid； Heart failure
