慢性心力衰竭患者检测N-末端脑钠肽前体的临床价值

目的：探讨检测血浆N-末端脑钠肽前体（NT-proBNP）水平对慢性心力衰竭（CHF）患者的诊断与疗效评估的临床价值。方法：将82例CHF患者按美国心脏病协会（NYHA）分级方法分为心功能Ⅱ级、Ⅲ级、Ⅳ级3组,30例健康人纳入对照组。采用胶体金免疫层析法床旁检测4组血浆NT-proBNP水平,用超声心动图测定左室舒张末期内径（LVEDD）和左心室射血分数（LVEF）。结果：CHF组NT-proBNP显著高于对照组（P〈0.01）;且血浆NT-proBNP水平随着心功能分级的增加而升高（3组两两比较均有统计学意义,P〈0.05）;CHF组血浆NT-proBNP浓度治疗后较治疗前降低（P〈0.05）;NT-proBNP水平随着LVEDD的增大而升高（P〈0.01）,随着LVEF的降低而升高（P〈0.01）。结论：血浆NT-proBNP水平可较好的反映CHF患者的心功能状态,可作为诊断CHF和判断CHF患者预后的指标。

Clinical Value of N-terminal Pro-brain Natriuretic Peptide Levels in Patients with Chronic Heart Failure

Objective：To access the clinical associates of plasma levels of N-terminal pro-brain natriuretic peptide （NT- proBNP） and its prognostic value in patients with chronic heart failure. Methods：A total of 82 patients with CHF were recruited and classified into class II , III and IV according to New York Heart Association （ NYHA ） functional classification. Additionally ,30 healthy people were recruited as a control group. Plasma levels of NT-proBNP were determined using colloidal gold immunochromatographic assay while left ventricular end diastolic diameter （LVEDD） and left ventricle eject fraction （LVEF） were calculated according to echocardiography. Results：Levels of NT-proBNP in CHF group were significantly greater （P 〈 O. 01 ） compared to control group;it was strongly associated with the severity of cardiac status （ statistically differences were shown among class ]I , Ill and IV groups, P 〈 O. 05 ）. In addition, plasma levels of NT- proBNP in patients with CHF decreased significantly （ P 〈 0.05 ） post-treatment. It was also shown that level of NT-proB- NP was in a significantly positive correlation （ P 〈 0.01 ） with LVEDD while in a significantly negative correlation （ P 〈 0.01 ） with LVEF. Conclusion：In this cohort, level of NT-proBNP is a good indicator of cardiac status of patients with CHF. This study also highlights the importance of using NT-proBNP level for both diagnosis and as prognostic indicator among patients with CHF in future.