| Objectives:Investigating the change of blood B-type natriureticpeptide(BNP), beta(2)-microglob ulin(β2-MG), cystatin C(Cys C)of patients with chronic heart failure, analysising correlati on between BNP and Cys C, β2-MG, to evaluate the diagnostic value of the receiver operat ing characteristic curve(ROC) for each indicators in chronic heart failure(CHF).Methods:221 patients were selected in my study including 101 cases(52 males, 49 females,68.01±13.98years) with chronic failure in the Second Hospital of Shanxi Medical University hospitalization from October 2013 to Junary 2016 as the investigation gruop,120 cases(56 males, 64 females, 65.79±10.16years) at the same periodwith CHF riskfactors but no symptoms of CHF as control group. The investigation group were divided into grade II-IV by NEW YERK Heart Association(NYHA) diagnostic criteria.The cases of CHF include hypertensive heart disease, Coronary arteriosclerotic heart disease,rheumatic heart disease, hypertrophic cardiomyopathy, dilated cardiomyopathy, ect.The relative examination of all the cases were completed on admission. The second day fasting test items including Cys C, β2-MG, BNP, rountine blood test. Liver and kidney function, ect.Result:(1)The concentrations of BNP, Cys C, β2-MG of CHF patients were higher than that of control group.(2)BNP was positively correlated with NYHA classification,(r=0.267,P=0.007),The concentration of BNP of Group of NYHA IV was higher than that of group of NYHA I I and III(P<0.05). The concentration of BNP between group of NYHA III and II had no st atistical significance(P>0.05). The concentration of Cys C and β2-MG between the three groups of investigation group had no statistical significance(P>0.05).(3)ROC curve showed: area under the curve(AUC) of BNP is0.800, an area of the standard error is 0.0272, the diagnosis of heart failure was significant(P < 0.05).According to this ROC curve, determining the optional cut point of BNP was 79.79pg/ml,the sensitivity is 79.2%, specificity is 80.0%.(4)ROC curves evaluated the sensitively and specificity of BNP tested individually was77.2% and 81.7%. Three indicators joint detection, diagnose sensitivity and specificity were 50.5% and 94.2%. Specificity of combined was higher than BNP single detection.Conclusions:1.Serum BNP,Cys C,β2-MG concentrations of CHF group are higher than that of conto rl group.BNP has a rising trenging with the increased of clinical heart function classificatio n.2.Serum BNP was weak correlation with β2-MG in CHF group.3.The concentrations of serum BNP,Cys C,β2-MG have diagnostic value on diagnosis of HF, but has no sensitivity to the cardiac function classification.4.Application of ROC curve in the evaluation of the three indicators in the specificity of th e diagnosis of CHF is higher than BNP individual test. |
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