Self-control study of changes in serum NT-proBNP on elderly hemodialysis and non-dialysis patients with heart failure
SUN Bo1,LIU Yuhua2,LI Sheng1,YAN Guoqiang1,SUN Yan1,CHEN Jie1,and WANG Yuee1
1. No.2 Department of Internal Medicine, Hospital Attached to Aeromedicine Institute of PLA, Beijing100089, China; 2. Hemodialysis?Center of No.205 Hospital of PLA, Jinzhou 121001, China
Abstract：Objective To evaluate the changes level of amino terminal brain natriuretic peptide(NT-proBNP) as well as its relationship between the changes and cardiac function classification in elderly maintenance hemodialysis patients with congestive heart failure. Methods Self-reflection Methods was used to analyze clinical data in 36 maintenance hemodialysis patients with congestive heart failure (hemodialysis heart failure group)aged≥60 years and compared with 38 non-maintenance hemodialysis patients with congestive heart failure (control group)aged≥60 years whose estimated glomerular filtration rate (eGFR) ＞60 ml/(min·1.73 m2) more than 60 years old among the same period in this hospital. The NT-proBNP level of different grades classified by NYHA (New York Heart Association) in the two group’s patients was measured after the treatment to improve cardiac function. ROC curve was used to evaluate diagnosis efficiency of NT–proBNP in different cardiac function classification of hemodialysis heart failure group. Results In hemodialysis heart failure group, compared with control group, NT-proBNP level of various cardiac function classification, median NT-proBNP values of Ⅰ, Ⅱ, Ⅲ, Ⅳ cardiac function classification respectively were significantly higher (P<0.05 or P<0.01). Comparing NT-proBNP level between different heart function classification in hemodialysis heart failure group, adjacent grading levels Ⅱ-Ⅳ also had significant difference (P<0.05 or P<0.01), and levels Ⅰ-Ⅱ have no significant difference (P>0.05). The same comparison in control group, adjacent grading levels Ⅰ-Ⅳ all have significant differences (P<0.05 or P<0.01). AUC value Results in hemodialysis heart failure group: AUC value in grade Ⅳ was 0.847, NT-proBNP>11 100 ng/L as boundary values, sensitivity was 83%, specificity was 79%; AUC value in grade Ⅲ was 0.794, NT-proBNP> 6465 ng/L as boundary values, sensitivity was 100%, specificity was 56.4%; cardiac function classification Ⅰ, Ⅱ were meaningless. Conclusions NT- proBNP can be regarded as diagnostic index and grading index of Ⅲ Ⅳ in elderly hemodialysis patients with congestive heart failure.
孙波,刘玉华,李晟,闫国强,孙岩,陈杰,王月娥. 氨基末端脑钠肽对老年血液透析合并充血性心力衰竭的心功能诊断分级的判断价值[J]. , 2014, 25(6): 566-569.
SUN Bo,LIU Yuhua,LI Sheng,YAN Guoqiang,SUN Yan,CHEN Jie,and WANG Yuee. Self-control study of changes in serum NT-proBNP on elderly hemodialysis and non-dialysis patients with heart failure. , 2014, 25(6): 566-569.
2014, Vol. 25 
