摘要目的 探讨血清N末端B型钠尿肽(Nt-proBNP)在老年充血性心力衰竭(CHF)患者中的诊断价值.方法 ELISA法检测80例老年CHF患者的血清Nt-proBNP水平,超声心动图测定LVEF≤45%,30例健康老年人作为正常对照组.结果 CHF患者NYHAⅡ级组、Ⅲ级组、Ⅳ级组各组间Nt-proB-NP水平有统计学意义,且均高于对照组(分别为1218±853.4 pmol/ml,2156±1543.5 pmol/ml,3667±2469.0 pmol/ml对239±67.76 pmol/ml,P<0.001).血浆Nt-proBNP水平与LVEF值呈负相关(r=-0.735,P<0.01).血清Nt-proBNP水平对CHF的诊断最适分界点为415 pmol/L时,其敏感性为92.5%,特异性为93.3%,阳性预测值为97.4%,阴性预测值为82.4%.结论 血清Nt-proBNP能有效诊断CHF,并能判断CHF的严重程度.

abstractsObjective To determine the diagnosis value of the concentration Nt-proBNP in elderly pa-tients with congestive heart failure. Methods Enzyme-linked immunosorbent assay method was used to measure the levels of serum Nt-proBNP in 80 patients diagnosed of CHF, and 30 healthy subjects serving as control group. 80 patients were diagnosed as chronic heart failure (CHF) with left ventricular ejection (LVEF) ≤45%. Results The levels of serum Nt-proBNP were much higher in CHF patients than those in the control group(P<0.001). There were significant differences of plasma Nt-proBNP level among NYHA Ⅱ, Ⅲ,and Ⅳ in CHF pa-tients(The 1218±853.4 pmol/ml,2156±1543.5 pmol/ml,3667±2469.0 pmol/ml vs 239±67.76 pmol/ml, P<0.01).The plasma level of Nt-proBNP had significant negative correlation with LVEF (r=-0.735,P<0.01). The cutoff value of Nt-proBNP for diagnosis of CHF was 415 pmol/L. The sensitivity,specificity,positive predictive values and negative predictive values was 92.5%,93.3%,97.4% and 82.4%, respectively. Conclu-sion Plasma Nt-proBNP level may be a valuable laboratory plasma marker for diagnosis of congestive heart fail-ure.