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目的探讨心力衰竭(心衰)患者发病时的N-末端B型利钠肽前体(NT-proBNP)在临床诊断、治疗及预后评估中的作用。方法测定200例2010年10月至2011年3月心衰患者发病时的NT-proBNP水平。1～12d内进行心脏彩超、胸部X线检查及抗心力衰竭药物治疗的效果评价,判断采用此方法对心力衰竭临床诊断及治疗指导的意义;出院时根据治疗前后NT-proBNP水平的对比,指导二级预防用药。结果 NT-proBNP诊断心衰的准确率为86.84%(99/114);通过NT-proBNP化验检测诊断为心衰并随后按心衰诊疗指南正规治疗后,总的好转率达91.23%(104/114),显示出良好的临床实用价值。结论 NT-proBNP在心衰的临床诊断、呼吸困难的鉴别、临床心衰治疗中的指导作用显著,可根据其水平对心衰进行危险分层,尽早治疗;出院时可根据治其水平的变化并与入院时的分析对照后做简易评估,指导二级预防用药。
Objective To investigate the role of NT-proBNP in the diagnosis, treatment and prognosis of patients with heart failure (CHF). Methods NT-proBNP levels were measured in 200 patients with heart failure from October 2010 to March 2011. 1 ~ 12d within the echocardiography, chest X-ray examination and anti-heart failure drug treatment evaluation, to determine the use of this method for clinical diagnosis and treatment of heart failure significance; discharged according to NT-proBNP levels before and after treatment, guidance Secondary prevention medication. Results The accuracy of NT-proBNP in diagnosis of heart failure was 86.84% (99/114). After NT-proBNP test was used to diagnose heart failure and then follow the guidelines of heart failure treatment, the overall improvement rate was 91.23% (104 / 114), showing a good clinical value. Conclusion NT-proBNP plays a guiding role in the clinical diagnosis of heart failure, the identification of dyspnea and the clinical treatment of heart failure. According to the level of NT-proBNP, the risk stratification of HF can be treated as soon as possible. And with the analysis of admission to do a simple evaluation, guidance secondary prevention medication.