目的探讨IL-18与N-末端脑钠素原（NT-ProBNP）联合检测对评估慢性心衰的意义。方法观察组为慢性心衰患者96例，对照组选自社区健康人群30例。分别检测血IL-18与NT-ProBNP并进行超声心动图检查明确LVEF及E/E'。结果对照组IL-18、NT-ProBNP和LVEF、E/E'检测结果均在参考值范围内，观察组患者IL-18、NT-ProBNP显著高于对照组（P<0.01），观察组LVEF、E/E'较对照组有显著性差异（P<0.05）。观察组心功能III级IL-18、NT-ProBNP较心功能II级者出现极显著性升高（P<0.01），LVEF、E/E'较心功能II级者有显著性升高（P<0.05）。心功能IV级患者IL-18、NT-ProBNP均较心功能II、III级患者显著升高（分别为P<0.01、P<0.05），LVEF、E/E'较心功能II级者有显著性升高（P<0.05），但较III级患者并无显著性差异（P>0.05）。IL-18+NT-ProBNP较IL-18、NT-ProBNP具有更高的灵敏度及特异度，而LVEF+E/E'联合诊断价值较IL-18+NT-ProBNP为差。结论 IL-18与NT-ProBNP联合检测有助于提高慢性心衰早期发现与诊断，并有助于判断病情进展。%Objective To investigate the diagnostic value of combined IL-18 and NT-ProBNP in the detection of chronic heart failure. Methods The observation group had 96 cases of patients with chronic heart failure,the control group were selected from the community healthy population with a total of 30 cases. Blood IL-18 and NT-ProBNP 、 LVEF and E / E 'were detected. Results IL-18,NT-ProBNP and the LVEF,E / E 'test results of the control subjects were within the reference range,IL-18,NT-ProBNP of observation group were significantly higher than those in the control group(P<0.01),LVEF, E/E ' of observation group compared with the control group had a significant difference(P<0.05). Observation group heart functional class III IL-18,the NT-ProBNP compared heart function Class II appeared significantly increase(P<0.01), LVEF,E / E had significantly increased 'than the cardiac function in Class II(P<0.05). IL-18,the NT-ProBNP of cardiac function patients with grade IV compared with cardiac function II,grade III patients was significantly higher(P<0.01, P<0.05),LVEF,E/E 'compared with heart function II level had significantly increased(P<0.05),although higher than Class III patients,there was no significant difference(P> 0.05). IL-18 + NT-ProBNP than IL-18,NT-ProBNP has higher sensitivity and specificity,and LVEF+E/E ' joint diagnostic value was worse than IL-18 + NT-ProBNP. Conclusion Combined detection of IL-18 and NT-ProBNP can help to improve the early detection and diagnosis of chronic heart failure,and help to determine the progress of the disease.
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