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目的:探讨中老年人血清脑钠肽(BNP)水平与年龄的相关性;评价根据年龄分层设定诊断界值的必要性和重要性。方法:选择96例心力衰竭患者和102例年龄和性别相匹配的体检健康人员(正常对照组)。按年龄分为3组:50~60岁为Ⅰ组,61~70为Ⅱ组,≥71岁为Ⅲ组。所有对象均测定血清BNP水平,采用Pearson线性相关分析法分析BNP与年龄的相关性。采用ROC曲线确定各年龄组中BNP在诊断心衰时的最佳临界值,计算各年龄组曲线下面积、比较不分组和按年龄分组后应用BNP诊断心衰时的准确性。结果:Pearson相关系数为0.347,P=0.016;ROC曲线分析结果显示:Ⅰ组最佳临界值为124.8 ng/ml,AUC面积为0.868;Ⅱ组最佳临界值为166.4 ng/ml,AUC面积为0.808;Ⅲ组最佳临界值为204.2 ng/ml,AUC面积为0.742。与不分组时的ROC曲线比较(AUC面积为0.689),分组后各组AUC面积均明显增大(P<0.05)。结论:中老年人血清BNP水平与年龄密切相关;应根据年龄分层界定BNP在中老年心力衰竭诊断中的临界值以提高诊断的准确性。
Objective: To investigate the relationship between serum brain natriuretic peptide (BNP) level and age in middle-aged and elderly people and to evaluate the necessity and importance of setting the diagnostic threshold according to age stratification. Methods: Ninety-six patients with heart failure and 102 healthy and age-matched healthy people (normal control group) were selected. Divided into three groups according to age: 50 to 60 years old for the group Ⅰ, 61 to 70 for the group Ⅱ, ≥ 71 years for the group Ⅲ. All subjects were measured serum BNP levels, Pearson linear correlation analysis of BNP with age-related. The optimal cutoff value of BNP in diagnosis of heart failure in each age group was determined by ROC curve. The area under the curve of each age group was calculated, and the accuracy of BNP in the diagnosis of heart failure was compared between non-grouping and age-grouping. Results: The Pearson correlation coefficient was 0.347, P = 0.016. The results of ROC curve analysis showed that the best cutoff value of group Ⅰ was 124.8 ng / ml and the area of AUC was 0.868. The best cutoff value of group Ⅱ was 166.4 ng / ml, 0.808; the best cutoff value of group Ⅲ was 204.2 ng / ml, and the area of AUC was 0.742. Compared with the ROC curve without grouping (AUC area: 0.689), the area of AUC in each group was significantly increased (P <0.05). Conclusion: The serum BNP level in middle-aged and elderly patients is closely related to age. The critical value of BNP in the diagnosis of heart failure in middle-aged and elderly people should be defined according to age to improve the diagnostic accuracy.