N末端B型脑钠肽前体在不典型心力衰竭诊断中的应用价值  

Value of N-terminal pro brain natriuretic peptide in diagnosis of atypical heart failure

作　　者：陈卫布[1] 庞新莉[2] 曹国磊[1] 

机构地区：[1]暨南大学第二临床医学院附属深圳市人民医院检验科急诊室,518020 [2]暨南大学第二临床医学院附属深圳市人民医院心内科,518020

出　　处：《中国医药》2014年第4期480-482,共3页China Medicine

摘　　要：目的 探讨N末端B型脑钠肽前体（NT-proBNP）对不典型心力衰竭的诊断价值.方法 选择深圳市人民医院2010年5月至2012年5月病房住院患者疑诊为临床症状不典型心力衰竭264例,检测血清NT-proBNP水平,同时完善胸部X线片、超声心动图等心功能不全相关辅助检查,比较NT-proBNP界值法、超声心动图参数法及实用内科学标准法对心力衰竭的阳性检出率.结果 NT-proBNP界值法、超声心动图参数法及实用内科学标准法评判,检出阳性率分别为93.9％（248/264）、70.1％（185/264）、58.3％（154/264）.阳性率采用非参数独立样本秩和检验比较,各组之间差异有统计学意义（Z=90.488,P=0.000）;3种评判方法两两比较,采用矫正检验水准α=0.017,NT-proBNP界值法与超声心动图参数法及实用内科学标准法评判阳性率比较,差异均有统计学意义（Z =50.849,P=0.000;Z =91.933,P=0.000）;超声心动图参数法及实用内科学标准法评判阳性率比较,差异有统计学意义（Z =7.904,P=0.005）.结论 NT-proBNP界值法在不典型心力衰竭中的诊断价值优于超声心动图参数法及实用内科学标准法评判法.Objective To discuss the value of N-terminal pro brain natriuretic peptide（NT-proBNP） in the diagnosis of atypical heart failure.Methods Totally 264 patients with suspected diagnosis of atypical heart failure from June 2011 to June 2013 in our hospital were selected and the serum levels of NT-proBNP were tested.The heart failure related auxiliary examination were examined such as X-ray for chest,ultrasonic cardiograph （UCG） for heart and so on.Heart failure was judged with the three methods of NT-proBNP boundary value; ultrasound graph parameter and the standard of Internal Medicine for heart failure and the positive rates of three methods were compared.Results The positive rates of three methods were 93.9％ （248/264）,70.1％ （185/264）,58.3％ （154/264） respectively.The positive rates of three methods were statistically different （Z =90.488,P =0.000）.There was a significant difference between NT-proBNP boundary value and ultrasound graph parameter （Z =50.849,P =0.000）.There was a significant difference between the methods of ultrasound graph parameter and the standard of internal medicine （Z =7.904,P =0.005）.Conclusion The NT-proBNP boundary value is better than the methods of ultrasound graph parameter and the standard of Internal Medicine regarding the diagnosis of atypical heart failure.

关 键 词：心力衰竭 N末端B型脑钠肽前体 诊断价值 

分 类 号：R541.6[医药卫生—心血管疾病]