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

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。

Clinical value of serum N-terminal B-type brain natriuretic peptide in diagnosis of heart failure

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（P0.01）,which increased gradually with the degree of Killip class（P0.05） and was positively related with the Killip class（r=0.774,P0.01）.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（P0.05） 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（P0.05）.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.