氨基末端B型钠尿肽原检测在心力衰竭诊断和治疗中的作用

The value of N-terminal Pro-brain natriuretic peptide level in diagnosis and treatment of heart failure

目的:研究氨基末端B型钠尿肽原(NT-proBNP)测定在心力衰竭(HF)诊治中的作用;方法:利用酶联免疫荧光法检测408例HF患者及50例正常对照NT-proBNP水平,并跟踪观察HF患者在治疗过程中NT-proBNP水平的变化;结果:408例HF患者血浆NT-proBNP测定值中位数为4 245 ng/L(1 535 ng/L^11 158 ng/L),明显高于非HF患者,差异有显著意义(P<0.001),且增高幅度与心功能不全严重程度有关,各分级间的差异有显著意义(P﹤0.05);治疗过程中随着患者病情好转,NT-proBNP水平有不同程度的下降;患者病情恶化则NT-proBNP水平进一步升高;结论:血浆NT-proBNP水平检测对HF患者初筛、早期诊断、不同程度患者评估、治疗及疗效监测具有重要临床价值。

Objective： To investigate the value of N- terminal Pro- brain natriuretic peptide （NT- proBNP） level in diagnosis and treatment of heart failure （HF）. Methods： Enzyme -linked immunosorbent fluorescence as- say was used to determine the NT - proBNP levels in 408 patients with HF and 50 heath volunteers. The dynamic changes of NT - proBNP level in patients were followed during the treatment. Results： The median for NT - proB- NP in HF patients （ n = 408 ） was 4245 ng/L （ 1535 ng/L - 11158 ng/L）, significantly higher than that from health volunteers （P 〈 0. 001 ）. NT - proBNP levels were positively correlated with the severity of heart failure development （ P 〈 0.05 ）. It decreased with ameliorated symptoms of HF after therapy and increased with deteriorated symptoms. Conclusion： Plasma NT- proBNP levels has important clinical value in initial screening, early diagnosis, assess- ment, treatment and monitoring of patients with varying degrees of heart failure.