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目的:探讨血浆N-末端脑利钠肽前体(NT-proBNP)检测对心源性脑栓塞(CE)的早期诊断价值。方法:急诊收治入院的200例急性脑梗死患者,按照TOAST分型标准进行分为大动脉粥样硬化型(n=58)、小动脉闭塞型(n=76)、心源性脑栓塞(n=41)、其他明确病因型(n=15)和不明原因型(n=10),比较各型在急诊检测的NT-proBNP水平。结果:CE组患者血浆NT-proBNP水平显著高于TOAST其他亚型组(P均<0.01),其他亚型组间的NT-proBNP无明显差异。当NT-proBNP取值(cut-off值)为412.42 pg/ml时,将CE组与其他TOAST各亚型组筛选出的敏感度为75.0%,特异度为88.7%。结论:急性脑梗死中,CE患者血浆NT-proBNP水平显著升高,急诊检测血浆NT-proBNP水平有助于CE的及早诊断。
Objective: To investigate the early diagnostic value of plasma N-terminal brain natriuretic peptide (NT-proBNP) in patients with cardiogenic cerebral embolism (CE). Methods: Two hundred patients with acute cerebral infarction admitted to the emergency department were divided into two groups according to TOAST classification: atherosclerosis type (n = 58), arteriolar occlusion type (n = 76), cardioembolism type (n = 41), other definite etiology (n = 15), and unexplained (n = 10) comparisons of NT-proBNP levels in various types of emergency tests. Results: The plasma levels of NT-proBNP in patients with CE were significantly higher than those in other TOAST subtypes (all P <0.01). There was no significant difference in NT-proBNP among other subtypes. When the NT-proBNP cut-off value was 412.42 pg / ml, the sensitivity and specificity of the CE and other TOAST subtypes were 75.0% and 88.7%, respectively. Conclusion: In patients with acute cerebral infarction, the plasma levels of NT-proBNP are significantly elevated in CE patients. The detection of plasma NT-proBNP levels in emergency patients is helpful for the early diagnosis of CE.