快速床边测定血浆N末端-前B型钠尿肽在急性心力衰竭患者中的临床价值

目的探讨快速床边测定血浆N末端-前B型钠尿肽（NT—proBNP）水平在急性心力衰竭诊断及评估预后中的应用价值。方法选择急性心力衰竭患者80例（病例组）、健康体检者40例（对照组），根据治疗期间是否发生心血管事件分为无事件组（48例）和事件组（32例），比较各组血浆NT—proBNP水平，分析血浆NT—proBNP水平与心功能、心血管事件的关系。结果病例组患者血浆NT—proBNP水平为（4198．90±152．42）．pg／ml，明显高于对照组的（91．86±11．75）pg／ml，差异有统计学意义（P〈0．05）。不同NYHA心功能分级患者血浆NT—ProBNP含量不同，差异具有统计学意义（P〈0．05）；急性心力衰竭患者血浆NT—ProBNP水平随着NYHA心功能分级的增加而升高，呈正相关（r=0．435，P=0．027）。事件组血浆NT—proBNP水平明显高于无事件组，差异有统计学意义（P〈0．05），15000pg／ml为最佳临界点。结论快速床边测定血浆NT—proBNP水平有助于急性心力衰竭的临床诊断，可评估患者早期发生心血管事件的风险，具有重要的临床应用价值。

CLINICAL VALUE OF RAPID BEDSIDE DETERMINATION OF PLASMA NT- PRO BNP IN PA- TIENTS WITH ACUTE HEART FAILURE

Objective To investigate the application value of rapid bedside determination of plasma NT - pro BNP levels in the diagnosis and prognosis evaluation of acute heart failure. Methods Tatolly 80 patients with acute heart failure （case group） and 40 healthy people who took health examination （con- trol group） were selected. The patients were divided into event- free group （48 patients） and event group （32 patients） according to the presence or absence of cardiovascular event during treatment. The plasma NT- pro BNP levels were compared among the groups, and the relationship between plasma NT- pro BNP levels and heart function and cardiovascular event was analyzed. Results The plasma NT- pro BNP levels in the patients of the case group was （4198.90-＋ 152.42）pg/ml, while that of the control group was （91.86- 11.75）pg/ml, the plasma NT- pro BNP levels of the case group was sig- nificantly higher, and the difference was statistically significant （P~0.05）. The plasma NT- pro BNP levels in patients with different NYHA heart function levels were different, and the difference was statistically significant （P~（0.05） ~ the plasma NT - pro BNP levels in patients with acute heart failure was increased following the increase of NYHA heart function level, and they were positively- correlative （r= 0. 435, P = 0. 027）. The plasma NT- pro BNP levels in patients of the event group was significantly higher than that of event- free group, the difference was statistically significant （P d0.05）, and 15 000pg/ml was the best critical point. Conclusion Rapid bedside determination of plasma NT- pro BNP level is helpful in the clinical diagnosis of acute heart failure, can evaluate the risk of early cardiovascular event in patients, and consequently has important clinical application value.