血浆BNP正常值建立及其在心血管疾病中诊断截断点探析.docVIP

血浆BNP正常值建立及其在心血管疾病中诊断截断点探析 　 作者：彭道荣　徐焰　张小宁　门可　余妍　孙怡群　郝晓柯 【关键词】 正常值范围 　 【摘要】 目的 建立西安地区健康人群血浆脑钠肽（BNP）的正常值范围，探讨BNP在心血管疾病中临床诊断截断点对心血管疾病诊断的可靠性。方法 采用微粒子酶免分析法，对西安地区健康人群血浆样本258份；不同心血管疾病患者血浆204份，进行血浆BNP浓度检测。结果 西安地区健康人群血浆BNP的正常值范围（微粒子酶免分析法）为0～38pg/ml；血浆BNP浓度冠心病组、心肌梗死组、心衰组的临床诊断截断点分别为4670pg/ml、7195pg/ml、11569pg/ml。各截断点对于相关疾病诊断的敏感性和特异性各不相同。不同心血管疾病组与正常组BNP浓度差异均有非常显著性（P＜001)。结论 建立本地区健康人群血浆BNP浓度的正常值范围，对于本地区患者相关疾病的诊断具有重要实用价值；不同心血管疾病血浆BNP诊断截断点各不相同，诊断截断点的建立可提高心血管疾病诊断的准确率。 【关键词】 血浆脑钠肽；正常值范围；心血管疾病；诊断截断点 　　Normal value range of plasma brain natriuretic peptide and study on diagnosis cut-off point of BNP levels in cardiovascular disease 　　【Abstract】 Objective To construct normal value range of plasma brain natriuretic peptide(BNP)in health adults from Xian area，study the clinical value of BNP levels as a diagnosis cut-off point for clinical diagnosis and therapeutic efficacy.Methods 258 plasma samples from health examination crowd and 204 plasma samples from cardiovascular disease patients had been selected to measure BNP levels by microparticle enzyme immunoassay.Results The normal value range of plasma brain natriuretic peptide (BNP)in health adults from Xian area were 0-38 pg/ml(microparticle enzyme immunoassay).The diagnosis cut-off point of BNP concentration in coronary heart disease,myocardial infarction,heart failure were 4670 pg/ml,7195 pg/ml,11569 pg/ml,respectively.There were significant differences in BNP levels among cardiovascular disease groups with normal group(P＜001).Conclusion Normal value range of plasma brain natriuretic peptide (BNP)can use to diagnosis.Measuring of diagnosis cut-off point of BNP levels might be a potential as markers of cardiovascular disease. 　　【Key words】 plasma brain natriuretic peptide;normal value range;cardiovascular disease;diagnosis cut-off point 　　脑钠肽（BNP）是继心房钠肽（ANP）之后发现的又一个心脏血管神经激素，血浆BNP浓度升高已被证实与心室容量的扩张和超负荷程度成正比［1］，其水平与纽约心脏协会（NYHA）心力衰竭分级呈正相关［2］，根据其高特异性、高敏感性的特征，该指标被认为是左心衰的重要标记物［3］。 　　诸多前瞻性临床试验证实BNP是心脏疾病一个较为敏感的指标［4］。新近报道心肌细胞的坏死以及局部压力的变化都可