缺血性心力衰竭患者尿NGAL水平与血清pro-BNP相关性及诊断价值分析
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摘要
目的:探讨缺血性心力衰竭患者尿NGAL水平与血清pro-BNP相关性及诊断价值。方法:选择宜城市人民医院和南漳县人民医院缺血性心力衰竭患者100例为病例组,同期于宜城市人民医院和南漳县人民医院门诊健康体检者96例作为对照组,测定两组尿NGAL水平与血清pro-BNP水平,分析其与缺血性心力衰竭疾病严重程度关系,探讨其诊断缺血性心力衰竭疾病的价值。结果:病例组NGAL、NT-pro BNP表达高于对照组(P<0.05);病例组CK、CTnL、hs-CRP表达高于对照组(P<0.05);病例组LAD、RAD水平高于对照组,LVEF水平低于对照组(P<0.05);随着心功能分级逐渐增加,NGAL、NT-pro BNP水平逐渐增加(P<0.05);NT-pro BNP与CK、CTnL、hs-CRP、LAD、RAD、心功能分级正相关关系明显,与LVEF负相关关系明显(P<0.01)。高水平的NGAL、NT-pro BNP以及低水平的LVEF均为缺血性心力衰竭发生的危险因素(P<0.05);NGAL、NT-pro BNP两者的AUC相近,皆小于LVEF,NGAL、NT-pro BNP诊断缺血性心力衰竭的灵敏度、特异度相近(P>0.05),皆小于LVEF(P<0.05)。结论:缺血性心力衰竭患者尿NGAL水平与血清pro-BNP明显升高,其与心功能分级、心脏损伤程度正相关关系明显;高水平的NGAL、NT-pro BNP以及低水平的LVEF均为缺血性心力衰竭发生的危险因素;NGAL、NT-pro BNP诊断缺血性心力衰竭具有较高的灵敏度、特异度,可作为判定缺血性心力衰竭的生物学标志物,值得临床上推广应用。
Objective: To investigate the diagnostic value and the correlation between urinary NGAL level and serum pro-BNP in patients with ischemic heart failure. Methods: 100 cases of ischemic heart failure(case group) and 96 cases of healthy individuals(control group) were selected. The levels of urinary NGAL and serum pro-BNP levels were detected, and the correlation with the disease severity was analyzed. Then the diagnosis value of the two indicators was further investigated. Results: The expression level of NGAL and NT-pro BNP was higher in the case group than in the control group(P<0.05). The expression level of CK, CTnL and hs-CRP was higher in the case group than in the control group(P<0.05). The case group had higher levels of LAD and RAD as well as lower level of LVE than those of the control group(P<0.05). With the increase of cardiac function grade, the levels of NGAL and NT-pro BNP gradually were increased(P<0.05); NT-pro BNP was positively correlated with CK, CTnL, hs-CRP, LAD, RAD, cardiac functional grading, and was negatively correlated with LVEF(P<0.01). High levels of NGAL, NT-pro BNP, as well as low levels of LVEF were risk factors for ischemic heart failure(P<0.05). The AUC of NGAL and NT-pro BNP were similar, suggesting that the sensitivity and specificity in the diagnosis of ischemic heart failure were similar(P>0.05), which was less than that of the LVEF(P<0.05). Conclusion: Urinary NGAL levels and serum pro-BNP are significantly elevated in patients with ischemic heart failure, which are positively correlated with the cardiac function grade and damage degree. High levels of NGAL, NT-pro BNP, as well as low levels of LVEF are risk factors for ischemic heart failure; The sensitivity and specificity of NGAL and NT-pro BNP for the diagnosis of ischemic heart failure are relatively high, which can used as biological markers and are worthy of promotion.
Objective: To investigate the diagnostic value and the correlation between urinary NGAL level and serum pro-BNP in patients with ischemic heart failure. Methods: 100 cases of ischemic heart failure(case group) and 96 cases of healthy individuals(control group) were selected. The levels of urinary NGAL and serum pro-BNP levels were detected, and the correlation with the disease severity was analyzed. Then the diagnosis value of the two indicators was further investigated. Results: The expression level of NGAL and NT-pro BNP was higher in the case group than in the control group(P<0.05). The expression level of CK, CTnL and hs-CRP was higher in the case group than in the control group(P<0.05). The case group had higher levels of LAD and RAD as well as lower level of LVE than those of the control group(P<0.05). With the increase of cardiac function grade, the levels of NGAL and NT-pro BNP gradually were increased(P<0.05); NT-pro BNP was positively correlated with CK, CTnL, hs-CRP, LAD, RAD, cardiac functional grading, and was negatively correlated with LVEF(P<0.01). High levels of NGAL, NT-pro BNP, as well as low levels of LVEF were risk factors for ischemic heart failure(P<0.05). The AUC of NGAL and NT-pro BNP were similar, suggesting that the sensitivity and specificity in the diagnosis of ischemic heart failure were similar(P>0.05), which was less than that of the LVEF(P<0.05). Conclusion: Urinary NGAL levels and serum pro-BNP are significantly elevated in patients with ischemic heart failure, which are positively correlated with the cardiac function grade and damage degree. High levels of NGAL, NT-pro BNP, as well as low levels of LVEF are risk factors for ischemic heart failure; The sensitivity and specificity of NGAL and NT-pro BNP for the diagnosis of ischemic heart failure are relatively high, which can used as biological markers and are worthy of promotion.
引文
[1] Angelidis G,Giamouzis G,Karagiannis G,et al.SPECT and PET in ischemic heart failure[J].Heart Failure Reviews,2017,22(2):243～261.
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[3] Katarzyna R.Adult stem cell therapy for cardiac repair in patients after acute myocardial infarction leading to ischemic heart failure:an overview of evidence from the recent clinical trials[J].Curr Cardiol Rev,2017,13(3):223～231.
[4] 陈文,朱继红.中性粒细胞明胶酶相关脂质运载蛋白与心血管疾病相关性的研究进展[J].中国全科医学,2017,20(27):3323～3327.
[5] Baumert M,Surmiak P,et al.Serum NGAL and copeptin levels as predictors of acute kidney injury in asphyxiated neonates[J].Clinical & Experimental Nephrology,2017,21(4):1～7.
[6] 中华医学会心血管病学分会.中国心力衰竭诊断和治疗指南2014[J].中华心血管病杂志,2014,42(2):3～10.
[7] Allawi AAD,Kahdem AA,Nada SZ,et al.Neutrophil gelatinase associated lipocalin (NGAL) in early detection of nephropathy in type 2 diabetic Iraqi patients[J].Journal of the Faculty of Medicine Baghdad,2017,59(1):45～47.
[8] Ribitsch W,Schilcher G,Quehenberger F,et al.Neutrophil gelatinase-associated lipocalin (NGAL) fails as an early predictor of contrast induced nephropathy in chronic kidney disease (ANTI-CI-AKI study)[J].Scientific Reports,2017,7(3):300～301.
[9] Noori NM,Teimouri A,Moghaddam M N.Diagnostic value of NT-pro BNP biomarker and echocardiography in cardiac involvements in beta-thalassemia patients[J].International Journal of Pediatrics,2017,5(11):6077～6094.
[10] Wang MZ,Yang F,Zhong XR.Significance of NT-pro BNP combined with bioelectrical impedance method in differential diagnosis of dyspnea in patients with stage 5 chronic kidney disease[J].Chinese & Foreign Medical Research,2017,23(2):123～125.
[2] Vedin O,Csp L,Koh A S,et al.Significance of ischemic heart disease in patients with heart failure and preserved,midrange and reduced ejection fraction:a nationwide cohort study[J].Circulation Heart Failure,2017,10(6):875～877.
[3] Katarzyna R.Adult stem cell therapy for cardiac repair in patients after acute myocardial infarction leading to ischemic heart failure:an overview of evidence from the recent clinical trials[J].Curr Cardiol Rev,2017,13(3):223～231.
[4] 陈文,朱继红.中性粒细胞明胶酶相关脂质运载蛋白与心血管疾病相关性的研究进展[J].中国全科医学,2017,20(27):3323～3327.
[5] Baumert M,Surmiak P,et al.Serum NGAL and copeptin levels as predictors of acute kidney injury in asphyxiated neonates[J].Clinical & Experimental Nephrology,2017,21(4):1～7.
[6] 中华医学会心血管病学分会.中国心力衰竭诊断和治疗指南2014[J].中华心血管病杂志,2014,42(2):3～10.
[7] Allawi AAD,Kahdem AA,Nada SZ,et al.Neutrophil gelatinase associated lipocalin (NGAL) in early detection of nephropathy in type 2 diabetic Iraqi patients[J].Journal of the Faculty of Medicine Baghdad,2017,59(1):45～47.
[8] Ribitsch W,Schilcher G,Quehenberger F,et al.Neutrophil gelatinase-associated lipocalin (NGAL) fails as an early predictor of contrast induced nephropathy in chronic kidney disease (ANTI-CI-AKI study)[J].Scientific Reports,2017,7(3):300～301.
[9] Noori NM,Teimouri A,Moghaddam M N.Diagnostic value of NT-pro BNP biomarker and echocardiography in cardiac involvements in beta-thalassemia patients[J].International Journal of Pediatrics,2017,5(11):6077～6094.
[10] Wang MZ,Yang F,Zhong XR.Significance of NT-pro BNP combined with bioelectrical impedance method in differential diagnosis of dyspnea in patients with stage 5 chronic kidney disease[J].Chinese & Foreign Medical Research,2017,23(2):123～125.