摘要
目的分析比较围生期心肌病(PPCM)患者血清N端脑钠肽前体(NT-proBNP)、肌钙蛋白I(cTnI)水平变化情况,以了解两者联合检测在PPCM早期诊断及鉴别诊断中的作用。方法采集79例PPCM患者(PPCM组)、同期妊娠生理反应妇女30例(妊娠生理反应组)、健康围生期妇女35例(健康对照组)静脉血,并分离血清。血清NT-proBNP测定采用电化学发光免疫分析(ECLIA)技术;cTnI的定量检测采用酶联免疫吸附(ELISA)法。结果 1)与健康对照组比较,PPCM组及妊娠生理反应组血清NT proBNP对数值均显著增高,差异有统计学意义(P<0.05);PPCM组血清cTnI水平显著高于健康对照组,差异有统计学意义(P<0.01);而妊娠生理反应组与健康对照组比较,血清cTnI水平差异无统计学意义(P>0.05)。2)与健康对照组比较,PPCM早期NYHA I级亚组血清cTnI水平显著增高,差异有统计学意义(P<0.05),而NT-proBNP对数值差异无统计学意义(P>0.05);妊娠生理反应组则正好相反。与健康对照组比较,PPCM早期NYHAⅡ级亚组上述2项指标均显著增高,差异有统计学意义(P<0.05)。3)血清NT-proBNP诊断早期PPCM的敏感性较高,特别是对NYHAⅡ级敏感性达100.0%,但特异性及阴性预测值极低,阳性预测值不足55.0%;而血清cTnI敏感性、特异性、阴性及阳性预测值均大于90.0%,表明血清cTnI水平对PPCM早期的鉴别诊断价值高于NT-proBNP。结论血清NT-proBNP、cTnI联合检测有助于PPCM早期诊断及鉴别诊断。
Objective To analyze and compare the changes of serum levels of N-terminal pro-brain natriuretic peptide（NT-proBNP）and cardiac troponin I （cTnI） in patients with peripartum cardiomyopathy （PPCM）, so as to investigate the clinical value of combined measurement of NT-proBNP and cTnI on early diagnosis and differential diagnosis of PPCM. Methods Totally 79 PPCM patients （PPCM group）, 30 cases with physiological pregnancy reaction （physiological pregnancy reaction group） and 35 healthy controls in perinatal period （healthy control group） were enrolled in the investigation. Venous blood samples were collected from all subjects and sera were isolated. Electrochemiluminescence immune assay was applied to measuring the level of serum NT- proBNP,and double antibody one-step sandwiched EI.ISA was adopted to quantitatively measuring the level of cTnI. Results 1）As compared with that in healthy control group, the logarithm value of serum NT-proBNP was significantly higher in PPCM group and physiological pregnancy reaction group, and the differences were statistically significant （P〈0. 05）. Serum level of cTnI was markedly higher in PPCM group than that in healthy control group （P〈0.01）, whereas there was no statistical difference in cTnI level between physiological pregnancy reaction group and healthy control group （P〉0.05）. 2）Serum level of cTnI in early PPCM NYHA I subgroup and logarithm value of serum NT-proBNP physiological pregnancy reaction group were significantly higher than those in healthy control group （P〈0.01）, while there was no significant difference in NT-proBNP value between NYHA 1 sub- group and healthy control group, so was in cTnI level between physiological pregnancy reaction group and healthy control group （P〉0.05）. The levels of serum NT-proBNP and cTnI were both increased in PPCM NYHA Ⅱ subgroup. 3）The diagnostic sensitivity of serum NT-proBNP for early PPCM was higher, especially for PPCM NYHA Ⅱ （100.0%）, but its specificity and negative predictive value were extremely low, and positive predictive value was below 55.0% ; on the contrary, as for serum cTnI, the sen- sitivity, specificity, negative and positive predictive value were all above 90.0%. It showed that the differential diagnostic value of serum cTnI on early PPCM was superior to that of serum NT-proBNP. Conclusion Combined measurement of serum NT-proBNP and cTnI contributes to early diagnosis and differential diagnosis of PPCM.
出处
《国际检验医学杂志》
CAS
2010年第8期783-785,共3页
International Journal of Laboratory Medicine
关键词
心肌疾病
利钠肽
脑
肌钙蛋白
实验室技术和方法
myocardial diseases
Natriuretic peptide,brain
Troponin
laboratory techniques and procedures
