NT-脑钠肽在左心功能不全诊断中的价值.doc

NT-脑钠肽在左心功能不全诊断中的价值
(作者:___________单位: ___________邮编: ___________)
作者:王光耀,何汉康,陈剑,周栋,韩明华
【摘要】目的探讨N末端脑钠肽(NT-BNP)在心功能不全诊断中的价值。方法对81例NYHA Ⅰ、Ⅱ、Ⅲ、Ⅳ级器质性心脏病患者,在入院治疗前抽肘静脉血,用酶免疫测定法测定NT-BNP;正常人36例为对照组,在体检时抽血检测NT-BNP。抽血当天超声心动图评估心功能不全时的相关指标,左室射血分数(LVEF)、左室舒张末径以及肺动脉压。结果对照组、Ⅰ、Ⅱ、Ⅲ、Ⅳ级器质性心脏病患者NT-、70、、、 pg/ml,NT-BNP对数均值为(±)、(2±)、(±)、(±)、(±),单因数方差分析差异有显著性(),若以256pg/ml为诊断左心衰临界值,其敏感性为97%,特异性为85%。NT-BNP与NYHA分级心脏功能指标的相关系数为(r=,)。诊断左心功能不全NT-BNP比心脏彩超有更高的敏感性和特异性。结论 NT-BNP是诊断左心衰竭快速、简便、敏感、特异的指标,也可用于判断左心衰竭严重程度。NT-BNP与肺动脉压有相互关系,测定NT-BNP并通过临床分析可为正确诊断心肺疾病提供有价值的信息。
【关键词】 N末端脑钠肽心室功能障碍左诊断
Clinical value of N-terminal proBNP in diagnosis of left heart failure
WANG Guang-yao, HE Han-kang, CHEN Jian, ZHOU Dong, HAN Ming-hua
(Cardiology Department, Liuzhou Traditional Chinese Medicine Hospital, Liuzhou, Guangxi 545001, China; Cardiology Department, the First Affiliated Hospital of Kunming Medical College, Kunming, Yunnan 650031, China)
Abstract: Objective To evaluate the clinical value of N-terminal proBNP (NT-BNP) in diagnosis of left heart failure. Methods According to NYHA classification, 81 patients with heart disease were divided into four groups, 15, 26, 22 and 18 cases in grades I, Ⅱ, Ⅲ and IV, respectively. 36 healthy individuals were selected as control group. NT-proBNP was detected using enzyme-immunoassay method in all subj