血清N末端B型脑钠肽前体在心力衰竭诊断中的临床价值
Clinical value of serum N-terminal B-type brain natriuretic peptide in diagnosis of heart failure
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摘要: 目的 探讨血清N末端B型脑钠肽前体(N-terminal B-type brain natriuretic peptide,NT-proBNP)水平变化在心力衰竭(heartfailure,HF)诊断中的价值。 方法 采用胶体金法检测152例HF患者、60例健康对照者血清NT-proBNP水平,同法检测75例HF(Ⅲ-Ⅳ级)患者经常规抗心衰治疗后第3天、第8天、第16天血清NT-proBNP水平,并进行统计分析。 结果 HF组血清NT-proBNP水平高于健康对照组(P<0.01),且随着心功能级数递增,血清NT-proBNP水平逐渐增高(P<0.05)。心功能Ⅰ-Ⅳ级组血清NT-proBNP水平高于健康对照组(P<0.01),且血清NT-proBNP水平与心功能分级呈正相关,(r=0.774,P<0.01)。不同疾病所致心衰患者血清NT-proBNP水平不尽相同,急性心肌梗死组血清NT-proBNP水平高于其他疾病组(P均<0.05),高血压组与缺血性心肌病组血清NT-proBNP水平较低。Ⅲ级组和Ⅳ级组治疗后血清NT-proBNP水平逐渐下降(P<0.05)。 结论 心力衰竭患者血清NT-proBNP水平明显升高,升高的程度和NYHA心功能分级相关,是诊断心力衰竭的良好指标。Abstract: Objective To study the clinical value of serum N-terminal B-type brain natriuretic peptide(NT-proBNP) level for the diagnosis of heart failure(HF). Methods NT-proBNP levels were measured with golloidal gold method in 152 HF patients,60 healthy controls and 75 HF patients on days 3,8 and 16 after routine anti-HF treatment. Results The serum NT-proBNP level was significantly higher in HF patients(Ⅰ-Ⅳ) than in healthy controls(P<0.01),which increased gradually with the degree of Killip class(P<0.05) and was positively related with the Killip class(r=0.774,P<0.01).The serum NT-proBNP levels were different in patients with HF due to different cardiovascular diseases,and significantly higher in patients with acute myocardial infarction than in those with other cardiovascular diseases(P<0.05) while significantly lower in patients with hypertension and ischemic myocardiopathy than in those with other cardiovascular diseases.The serum NT-proBNP level decreased gradually in patients with Killip class Ⅲ and Ⅳ after treatment(P<0.05). Conclusion The serum NT-proBNP level is significantly higher in HF patients,which is related with the NYHA functional classification,and is thus a good indication for the diagnosis of HF.