摘要
目的:探讨不同时间检测N末端-脑钠肽前体(NT-proBNP)对心功能正常的不稳定型心绞痛(UAP)患者的诊断价值。方法:入选可疑UAP患者55例,发病在18h内,于症状发作后18h及症状缓解96h时两次测定血浆NT-proBNP;经冠状动脉(冠脉)造影确诊冠脉病变阳性组41例,冠脉病变阴性组14例,比较两组的NT-proBNP水平,并应用ROC曲线分析两个时间点的NT-proBNP对UAP的诊断价值。结果:冠脉病变阳性组两次NT-proBNP均明显高于冠脉病变阴性组(P<0.01);冠脉病变阳性组内第1次NT-proBNP水平高于第2次(P<0.01);ROC曲线分析显示,症状发作18h时的NT-proBNP更适用于UAP的辅助诊断(P=0.000),且NT-proBNP水平在92.66pg/ml时,其诊断UAP的灵敏度为90.2%,特异度为78.6%,阳性预测值为92.5%,阴性预测值为73.3%。结论:血浆NT-proBNP是一种对急性心肌缺血较敏感的生物学标志物,心绞痛症状发作早期测定对UAP的辅助诊断价值最大。
Objective：To explore the diagnostic value of N-terminal pro-brain natriuretic peptide（NT-proBNP） at different time in unstable angina pectoris （UAP）patients with normal cardiac function.Method：Fifty-five patients with suspected UAP were enrolled and unstable angina pectoris happened within 18hours.All patients underwent coronary angiography underwent coronary angiography（CAG）and divided into two groups：CAG（＋） group with 41patients and CAG（-）group with 14patients.NT-proBNP was determined at 18hafter symptom broke out and 96hafter symptom palliation.Then we compared the levels of NT-proBNP between the two groups.ROC curve was used to analysis the diagnosis value of NT-proBNP for UAP.Result：The NT-proBNP in CAG（＋）group was much higher than that in CAG（-）group both at 18hand 96h（both P〈0.01）.In CAG （＋）group,the level of NT-proBNP at 18hwas higher than that at 96h（P〈0.01）.ROC curve showed that the NT-proBNP 1 8was more applicable for the diagnosis of UAP（P =0.000）,and when NT-proBNP level was 9 2.6 6pg/ml,the diagnosis sensitivity was 9 0.2%and specificity was 7 8.6% ,the positive predictive value was 92.5%and negative predictive value was 73.3%.Conclusion：Plasma NT-proBNP is a sensitive biological indicator for myocardial ischemia.Moreover,early detection of NT-proBNP after angina attacks will take great auxiliary diagnostic value to UAP.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2013年第6期432-434,共3页
Journal of Clinical Cardiology
关键词
心绞痛
不稳定型
N末端-脑钠肽前体
心肌缺血
angina pectoris
unstable
N-terminal pro-brain natriuretic peptide
myocardial infarction
