胡卫中,
甘甜,
何婧,
夏晓蓉,
袁一民,
夏纪筑^,
西南医科大学附属医院 超声医学科, 核医学与分子影像四川省重点实验室, 四川 泸州 646000

详细信息 作者简介: 胡卫中(1994-), 男, 硕士研究生。E-mail: 229009664@qq.com






通讯作者: 夏纪筑, 副教授。E-mail: xjz71@163.com 中图分类号: R445.1


摘要:目的研究甲亢性心脏病患者血清N端B型脑钠肽前体（NT-proBNP）水平与心脏大小关系及其在甲亢性心脏病诊断中的效能，为临床早期诊断提供参考。方法选取甲亢患者51例（甲亢组），甲亢性心脏病患者28例（甲亢性心脏病组），分别进行超声心动图检查及血液检测，比较两组患者的心脏大小、射血分数以及甲状腺激素、NT-proBNP的差异，分析心脏大小与NT-proBNP水平的相关性并评估左房前后径和NT-proBNP单独或联合检测之间的诊断效能。结果甲亢性心脏病组整个心脏房、室大小均大于甲亢组（P < 0.05），左室射血分数低于甲亢组（P < 0.05）；NT-proBNP与左房前后径呈中度正相关（r=0.447，P < 0.001）；当左房前后径≥32.5 mm时，曲线下面积（AUC）为0.912，灵敏度82%，特异度90%；NT-proBNP≥574.95 ng/L时，曲线下面积（AUC）为0.856，灵敏度71%，特异度96%；两者联合时，曲线下面积（AUC）为0.924，灵敏度86%，特异度94%。结论左房前后径和血清NT-proBNP联合检测一定程度上可帮助临床对甲亢性心脏病做出早期、准确诊断，从而及时处理。
关键词: 甲亢性心脏病/
NT-proBNP/
左房前后径


Abstract:ObjectiveTo study the relationship between NT-proBNP and cardiac size in patients with hyperthyroid heart disease and the diagnosis efficacy of these two characteristics for hyperthyroid heart disease, which could provide a reference for clinical diagnosis.MethodsEchocardiography (for cardiac size and LVEF) and serum tests (for thyroid hormone and NT-proBNP) were performed in 51 patients with hyperthyroidism and 28 with hyperthyroid heart disease. The cardiac size, LVEF, thyroid hormone and NT-proBNP were then compared. The relationship of NT-proBNP and cardiac size, and the diagnosis efficacy of these two characteristics for hyperthyroid heart disease were analyzed.ResultsThe cardiac size of patient with hyperthyroid heart disease was larger than that with hyperthyroidism (P < 0.05), however the LVEF was lower (P < 0.05). NT-proBNP and left atrial diameter were positively correlated (r=0.447, P < 0.001). When the left atrial diameter was higher than 32.5 mm, the area under the curve (AUC) was 0.912, sensitivity was 82% and specificity was 90%, when NT-proBNP was higher than 574.95 ng/L, the AUC was 0.856, sensitivity was 71% and specificity was 96%, when the two were combined, the AUC was 0.924, sensitivity was 86% and specificity was 94%.ConclusionThe combination of NT-proBNP and left atrial diameter could help early and accurate clinical diagnosis of hyperthyroid heart disease.
Keywords:hyperthyroid heart disease/
NT-proBNP/
left atrial diameter

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