本文選題：慢性收縮性心力衰竭　切入點(diǎn)：黃嘌呤氧化酶　出處：《石河子大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:本研究探討慢性收縮性心力衰竭患者中血清黃嘌呤氧化酶(Xanthine Oxidase,XO)與B型鈉尿肽(B-Type Natriuretic Peptide,BNP)、肌鈣蛋白T(Troponin T,c Tn T)之間的關(guān)系,并評(píng)價(jià)XO在慢性收縮性心衰患者中的診斷價(jià)值,旨在為慢性收縮性心衰提供一個(gè)新的診斷指標(biāo)。方法:于2015-07~2016-07期間,根據(jù)《中國(guó)心力衰竭診斷和治療指南2014》在新疆維吾爾自治區(qū)人民醫(yī)院心內(nèi)科住院患者中選擇符合慢性收縮性心力衰竭(heart failure with reduced ejection fraction,HF-REF)診斷標(biāo)準(zhǔn)的患者94例為病例組。同期選擇在我科住院的患有其他心臟疾病的非心衰患者90例為對(duì)照組。排除不符合慢性收縮性心力衰竭的診斷標(biāo)準(zhǔn)、腎功能不全、痛風(fēng)、慢性阻塞性肺疾病、心臟或血管惡性腫瘤或先天畸形、新發(fā)的心肌梗死(1個(gè)月)、血液系統(tǒng)疾病、妊娠、系統(tǒng)性紅斑狼瘡等疾病。采用酶聯(lián)免疫法檢測(cè)XO的活性。采用雙抗體夾心酶聯(lián)免疫(ELISA)法進(jìn)行CTn T的檢測(cè)。BNP水平測(cè)定采用(美國(guó)Biosite公司)博適Triage床邊快速定量心肌梗死心衰診斷儀。并收集兩組研究對(duì)象的年齡、身高、體重、血壓等基線資料。探討XO與BNP、c Tn T之間的關(guān)系,計(jì)算黃嘌呤氧化酶診斷試驗(yàn)的靈敏度、特異度及Youden指數(shù),繪制受試者工作曲線(ROC曲線),從而更好地評(píng)價(jià)該診斷試驗(yàn)的診斷價(jià)值。結(jié)果:1.各組間基本資料之間的比較,發(fā)現(xiàn)兩組間年齡、體重、身高、BMI差異均無(wú)統(tǒng)計(jì)學(xué)意義。2.XO與BNP呈正相關(guān),且相關(guān)程度較強(qiáng),與CTn T也呈正相關(guān),但相關(guān)程度較弱。3.診斷慢性收縮性心衰中XO的ROC曲線下面積為(AUGROC=0.791),提示該診斷標(biāo)準(zhǔn)有一定準(zhǔn)確性,在臨床應(yīng)用中診斷價(jià)值中等。4.本試驗(yàn)通過(guò)Youden指數(shù)(正確診斷指數(shù))得出XO診斷慢性收縮性心衰中最理想臨界點(diǎn)為:3633.1pg/ml,其靈敏度0.734、特異度0.733、陽(yáng)性預(yù)測(cè)值0.74、陰性預(yù)測(cè)值0.73。結(jié)論:慢性收縮性心力衰竭患者中血清黃嘌呤氧化酶(XO)與B型鈉尿肽(BNP)、肌鈣蛋白T(c Tn T)呈正相關(guān)。血清黃嘌呤氧化酶(XO)對(duì)慢性收縮性心力衰竭的診斷價(jià)值中等,其診斷的最佳臨界點(diǎn)為3633.1pg/ml。
[Abstract]:Objective: To study the serum xanthine oxidase in patients with chronic systolic heart failure (Xanthine Oxidase XO) and B type natriuretic peptide (B-Type Natriuretic, Peptide, BNP), T (Troponin T C, troponin Tn T) the relationship between, and evaluate the diagnostic value of XO in patients with chronic systolic heart failure, in order to provide a new diagnostic index for chronic systolic heart failure. Methods: during the period of 2015-07~2016-07, according to the China guidelines for the diagnosis and treatment of heart failure in the choice of 2014> compliance in patients with chronic congestive heart failure in hospital department of Cardiology, people's Hospital of the Xinjiang Uygur Autonomous Region (heart failure with reduced ejection fraction, HF-REF) in 94 cases of diagnostic criteria for patients at the same period. In our hospital with other heart disease non heart failure patients 90 cases as control group. The diagnostic standards are not consistent with the exclusion of chronic systolic heart failure, kidney The function is not complete, gout, chronic obstructive pulmonary disease, cardiac or vascular tumors or congenital malformations, new onset myocardial infarction (1 months), blood system diseases, pregnancy, systemic lupus erythematosus and other diseases. ELISA was used to examine the activity of XO. By using double antibody sandwich ELISA (ELISA CTn T) method to detect the level of.BNP was determined by the (American Biosite company) for myocardial infarction heart failure diagnosis instrument Bo Triage bedside rapid quantitative. And of the two groups were collected. The age, height, weight, blood pressure and other baseline data. To investigate the XO and BNP, the relationship between C Tn T and the sensitivity calculation of xanthine oxidase diagnostic test the specificity and Youden index, receiveroperating curve (ROC curve), so as to better evaluate the diagnostic value of diagnostic test. Results: the comparison between the 1. groups of the basic data, found that two groups of age, weight, height, the difference was BMI No statistical significance of.2.XO and BNP were positive, and the degree of correlation is strong, positive correlation with the CTn T, but the area of ROC curve and low degree of.3. in the diagnosis of chronic systolic heart failure in under the XO (AUGROC=0.791), suggesting that the diagnostic standard of a certain accuracy, in the clinical application of diagnostic value of this test by Youden index medium.4. (correct diagnosis index) that XO diagnosis of ideal critical point for chronic systolic heart failure: 3633.1pg/ml, its sensitivity was 0.734, specificity 0.733, positive predictive value of 0.74, negative predictive value of 0.73. conclusion: the serum xanthine oxidase in patients with chronic systolic heart failure (XO) and in B type natriuretic peptide (BNP). Troponin T (C Tn T). Positive correlation of serum xanthine oxidase (XO) in the diagnosis of chronic congestive heart failure secondary value, the best critical point for the diagnosis of 3633.1pg/ml.

【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R541.6

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