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目的检测老年冠心病慢性心力衰竭(CHF)患者血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和血清N末端B型利钠肽原(NT-pro BNP)的水平变化,探讨血清NGAL水平与NT-pro BNP和肾功能指标的相关关系及其对老年冠心病CHF患者早期肾损害的诊断价值。方法测定54例老年冠心病CHF患者、30例老年冠心病心功能代偿患者和31例老年健康者血清NGAL和NT-pro BNP水平。采用Pearson相关分析得出血清NGAL水平与NT-pro BNP和肾功能指标的相关关系。应用受试者操作特征(ROC)曲线评价血清NGAL诊断早期肾损害的准确性。结果老年冠心病CHF患者血清NGAL和NT-pro BNP水平均明显高于心功能代偿患者和老年健康者,3组血清NGAL和NT-pro BNP水平两两比较差异均有统计学意义(P<0.01或P<0.05)。老年冠心病CHF患者血清NGAL水平与NT-pro BNP、Scr、BUN、Um ALB呈正相关(r值分别为0.809、0.553、0.439、0.441,P均<0.01);与估计肾小球滤过率(e GFR)呈负相关(r值为-0.563,P<0.01)。血清NGAL诊断肾功能不全的ROC曲线下面积为0.884,敏感度和特异度分别为93.5%和84.5%。结论血清NGAL是反映老年冠心病CHF患者心衰病情严重程度和诊断早期肾损害的较好指标。
Objective To detect the level of serum neutrophil gelatinase-associated lipocalin (NGAL) and serum N-terminal pro-brain natriuretic peptide (NT-pro BNP) in elderly patients with chronic heart failure (CHD) Correlation between NT-pro BNP and renal function and its diagnostic value for early renal damage in CHF patients with senile coronary heart disease. Methods The serum levels of NGAL and NT-pro BNP in 54 senile CHF patients, 30 elderly patients with CHD and 31 elderly controls were measured. Pearson correlation analysis was used to determine the correlation between serum NGAL level and NT-pro BNP and renal function. The receiver operating characteristic (ROC) curve was used to evaluate the accuracy of serum NGAL in the diagnosis of early renal impairment. Results The levels of serum NGAL and NT-pro BNP in senile patients with coronary heart disease were significantly higher than those with decompensated cardiac function and elderly patients. There was significant difference in serum NGAL and NT-pro BNP level between the two groups (P < 0.01 or P <0.05). The levels of serum NGAL in elderly CHF patients were positively correlated with NT-pro BNP, Scr, BUN and Um ALB (r = 0.809, 0.553, 0.439 and 0.441, respectively, P <0.01) e GFR) (r value -0.563, P <0.01). The area under the ROC curve of serum NGAL for diagnosing renal insufficiency was 0.884, with a sensitivity and specificity of 93.5% and 84.5%, respectively. Conclusion Serum NGAL is a good indicator to reflect the severity of CHF and the diagnosis of early renal damage in elderly patients with CHF.