| 李 佳,刘志娟,孙海霞,李 方,苏玉鑫,李 玮.心脏彩超与N末端脑钠肽在H型高血压心功能不全中的临床诊断价值比较[J].,2018,(20):3922-3924 |
| 心脏彩超与N末端脑钠肽在H型高血压心功能不全中的临床诊断价值比较 |
| Comparison of the Clinical Diagnostic Value of Cardiac Color Doppler and N Terminal Brain Natriuretic Peptide for H Type Hypertensive Cardiac Insufficiency |
| 投稿时间：2018-03-07 修订日期：2018-04-03 |
| DOI：10.13241/j.cnki.pmb.2018.20.027 |
| 中文关键词: 心脏彩超 N末端脑钠肽 H型高血压心功能不全 临床诊断价值 |
| 英文关键词: Cardiac color Doppler ultrasound N terminal brain natriuretic peptide H type hypertensive cardiac insufficiency Clinical diagnostic value |
| 基金项目:青海省科技厅基金项目（2013-z-919） |
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| 中文摘要: |
| 摘要 目的：对比分析心脏彩超与N末端脑钠肽(NT pro BNP)在H型高血压心功能不全中的临床诊断价值。方法：选择2016年1月～2017年12月在我院进行诊治的119例H型高血压心功能不全患者，采用美国纽约心脏病学会(NYHA)分级方案将患者的心功能等级分成Ⅰ级组、Ⅱ级组、Ⅲ级组、Ⅵ级组，并选取同期在我院诊治的Hcy正常的116例高血压患者。检测所有患者的NT pro BNP水平，并采取心脏彩超检测患者的左心房内径(LAD)、左室舒张末期内径(LVEDd)以及左室射血分数(LVEF)。结果：H型高血压组的LAD、LVEDd、NT pro BNP水平明显高于Hcy正常高血压组(P<0.05)，LVEF明显低于Hcy正常高血压组(P<0.05)；NT pro BNP和LVEF的阳性率随着H型高血压患者心功能分级的增加，呈上升趋势。不同心功能分级患者NT pro BNP和LVEF的阳性率相比差异具有统计学意义(P<0.05)；H型高血压患者的Hcy水平与LAD呈明显的正相关(r=0.647，P=0.000)，LVEDd呈明显的正相关(r=0.613，P=0.000)，LVEF呈明显的负相关(r=-0.739，P=0.000)，NT pro BNP呈明显的正相关(r=0.832，P=0.000)。LVEF诊断心功能不全的AUC为0.798，临界值为52.7%，敏感性为83.3%，特异性为57.3%；NT pro BNP诊断心功能不全的AUC为0.802，临界值为260.3 pg/mL，敏感性为85.7%，特异性为58.3%。结论：心脏彩超和NT pro BNP诊断H型高血压心功能不全患者的临床价值较高，可为其诊断提供有效的参数依据。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the clinical diagnostic value of cardiac color Doppler and N terminal brain natriuretic peptide in H type hypertensive cardiac insufficiency. Methods: Selected 119 cases of patients with H type hypertensive cardiac insufficiency who were treated in our hospital from January 2016 to December 2017, Using the American New York heart association (NYHA) classification scheme the level of cardiac function of patients can be divided into Ⅰ level, Ⅱ grade group, Ⅲ group, the level Ⅵ group. The levels of NT Pro BNP in all patients were detected, and the left atrial diameter (LAD), left ventricular end diastolic diameter (LVEDd) and left ventricular ejection fraction (LVEF) were detected by echocardiography. Results: The level of LAD, LVEDd and NT Pro BNP in H type hypertension group was significantly higher than that of normal hypertensive group of Hcy (P<0.05), and LVEF was significantly lower than that of normal hypertension group (P<0.05); The positive rate of NT Pro BNP and LVEF increased with the increase of cardiac function classification in patients with H type hypertension. The positive rates of NT Pro BNP and LVEF were statistically significant compared with the patients with different cardiac function classification(P<0.05); The level of Hcy in patients with type H hypertension was positively correlated with LAD (r=0.647, P=0.000), and had positive correlation between LVEDd (r=0.613, P=0.000), and had negative correlation with LVEF (r=-0.739, P=0.000). The AUC of LVEF in diagnosis of cardiac insufficiency was 0.798, the critical value was 52.7%, the sensitivity was 83.3%, and the specificity was 57.3%. The AUC of NT pro BNP in diagnosis of cardiac insufficiency was 0.802, and the critical value was 260.3 pg/mL. It is 85.7% and its specificity is 58.3%. Conclusion: Cardiac color Doppler ultrasound and NT Pro BNP have high clinical diagnostic value in patients with type H hypertensive cardiac insufficiency, which can provide effective parameters for their diagnosis. |
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