血浆NT-proBNP与CRP联合检测在陈旧性心肌梗死心力衰竭诊断中的应用价值

摘要

目的：探讨陈旧性心肌梗死心力衰竭患者血浆 N末端 B型利钠肽原（NT-proBNP）、C反应蛋白（CRP）水平的变化，为其在临床诊断预测中应用提供理论依据。方法选择我院2011年8月至2013年7月收治的确诊为陈旧性心肌梗死患者536例，按是否合并心力衰竭分为心衰组（214例）和非心衰组（322例），采用NYHA分级标准对患者心功能进行评定，比较 NYHA心功能各级 NT-proBNP和 CRP水平。结果心衰组患者 BMI、SBP、SDP、HR、糖尿病、PCI史、CABG史、心功能分级、左房内径、LVEDD、LVEF、心房颤动、Scr、NT-proBNP和 CRP与非心衰组患者比较，差异有统计学意义（P＜0．05），性别、年龄和高血压差异无统计学意义（P＞0．05）；NYHA 心功能各级 NT-proBNP、CRP比较存在差异（P＜0．05），且各级间两两比较也存在差异，差异均有统计学意义（P＜0．05）。结论血浆 NT-proBNP与CRP联合检测有助于陈旧性心肌梗死心力衰竭的诊断及对心力衰竭程度进行分级。%Objective To study the changes of plasma NT-proBNP (N-terminal B-type natriuretic peptide original), in CRP(C-reactive protein)levels of patients with old myocardial infarction,heart failure,and its application in clinical diagnostics to provide a theoretical basis for prediction.Methods Selected 5 3 6 cases patients who were diagnosed as old myocardial infarction from our hospital from August 2011 to July 2013,according to whether the merger heart failure divided into heart failure group(214 cases)and non-heart failure group(322 cases),using the NYHA classification cri-teria for assessment of cardiac function,NT-proBNP and CRP levels compare.Results Between non-heart failure group and heart failure group,BMI,SBP,SDP,HR,diabetes,PCI history,CABG history,NYHA functional class,left atrial diameter,LVEDD,LVEF,atrial fibrillation,Scr,NT-proBNP,CRP there are differences,the difference was statis-tically significant (P<0.05),gender,age,hypertension was no significant difference (P> 0.05);NYHA heart function at all levels of NT-proBNP,CRP comparison not all equal (P <0.05),pairwise comparisons between the various levels and there are also differences,the differences were statistically significant (P <0.05).Conclusion The plasma NT-proBNP and CRP can help diagnose heart failure with old myocardial infarction and heart failure degree classification.