NT-proBNP在心血管疾病诊断中的应用进展

Application of NT-proBNP in the diagnosis of cardiovascular disease

NT—proBNP能够有助于诊断和鉴别诊断心力衰竭，是很好的血浆标志物。对于失代偿心力衰竭，目前建议NT-proBNP采用排除截点和诊断截点的双截点策略，并按照年龄进一步划分诊断截点，可进一步提高诊断准确性。对于灰色区间的患者，临床应进一步分析可能的混杂因素，包括年龄、肾功能、BMI等。近来，NT-proBNP在急性冠状动脉综合征的患者中也开展了不少研究，并有研究认为其与肌钙蛋白结合能够增加急性心肌梗死的诊断效果。NT-proBNP还在心房颤动、心肌病、瓣膜病、肺栓塞的患者中开展了相应的研究，并取得了有益临床应用的结果。

N-terminal pro-B-type natriuretic peptide （NT-proBNP） is a good plasma marker for the diagnosis and differential diagnosis of the heart failure. For decompensated heart failure, the double-cut-point strategy including the diagnostic cut-off point and eliminated cut-off point was suggested, and the diagnostic cut-off point can be further divided according to age to further improve the diagnostic accuracy. If the patient＇s value was in gray interval, doctors should further analyzed the possible confounders, including age, renal function, BMI et al. Recently, more researches were carried out for NT-proBNP in patients with acute coronary syndrome, and some studies showed that its combination with troponin increased the diagnostic efficacy of acute myocardial infarction. The studies of NT-proBNP were still carried out in other areas including atrial fibrillation, cardiomyopathy, valvular disease, pulmonary embolism et al and had obtained the results of the beneficial clinical applications.