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氨基末端脑钠肽前体在心力衰竭检测中的临床意义沈军瑾【摘要】目的:探讨充血性心力衰竭患者血浆氨基末端脑钠肽前体(NT-proBNP)水平的变化.方法:应用电化学发光免疫分析仪测定健康人组80例和心力衰竭组80例(心功能Ⅱ级25例、Ⅲ级30例、Ⅳ级25例)血清NT-proBNP的水平.结果:心力衰竭组NT-proBNP水平较健康组明显增高,且随心功能的恶化NT-proBNP水平增高.结论:充血性心力衰竭患者血清NT-proBNP水平明显增加,且随着心功能分级程度的加重而显著增加.【期刊名称】《实用中西医结合临床》【年(卷),期】2010(010)005【总页数】2页(P72-73)【关键词】心力衰竭;充血性;NT-proBNP【作者】沈军瑾【作者单位】江西省肿瘤医院,南昌,330029【正文语种】中文【中图分类】R541.61心力衰竭（heart failure，HF）是各种心脏疾病导致的心功能不全的一种综合征，绝大多数情况下是指心肌收缩力下降使心排血量不能满足机体代谢的需要，器官、组织血液灌注不足，同时出现肺循环和（或）体循环瘀血的表现。
心力衰竭时通常伴有肺循环和（或）体循环的被动性充血，故又称之为充血性心力衰竭（CHF）[1]。
血浆氨基末端脑钠肽前体（NT-ProBNP）已被确认为是心力衰竭早期的标志物，且增高水平同心力衰竭严重程度以及预后情况明显相关[2]。
1 对象和方法1.1 研究对象1.1.1 心力衰竭组选择2009年1月～2010年3月已确诊心力衰竭住院患者80例（除外糖尿病、肥胖等因素），年龄34～90岁，男性42例，女性38例，并按美国纽约心脏病协会（NYHA）的分级标准分级，心功能Ⅱ级25例、Ⅲ级30例、Ⅳ级25例。
1.1.2 对照组选择年龄及性别相匹配的在本院体检中心体检的健康人80例，年龄35～88岁，男性40例，女性40例，均无心脏病史，无心力衰竭症状，各项身体检查均正常。
1.2 采集标本的处理及保存所有血样均在7：30～8：30空腹采集，12：00前测定完毕。
老年EH伴HF-PEF患者血浆NT-proBNP、E/A及LVMI值的变化及其诊断价值吴兴雷，金叶上海市奉贤区中心医院急诊医学科,上海201499[摘要]目的探讨老年原发性高血压（EH）射血分数保留的心力衰竭（HF-PEF）患者血浆氨基末端脑钠肽前体（NT-proBNP）、二尖瓣口舒张早期最大血流峰值（E峰）/二尖瓣心房收缩期最大血流峰值（A峰）、左心室质量指数（LVMI）的变化及其意义。
方法选取2017年3月~2019年5月确诊的老年EH伴HF-PEF患者90例作为HF-PEF组、另外90例单纯EH患者作为EH组.采用ELISA法检测2组的血浆NT-proBNP水平，采用超声心动图检测2组的左室射血分数（LVEF）、左室舒张末期内径（LVEDD）、E/A及LVMI值，采用受试者工作曲线（ROC）分析NT-proBNP、E/A及LVMI值鉴别诊断EH患者并发HF-PEF的价值。
结果HF-PEF组的血浆NT-proBNP水平高于EH组，E/A值低于EH组，LVMI值高于EH组，差异均有统计学意义（<0.05）；但2组LVEF、LVEDD值的差异无统计学意义（>0.05）。
ROC曲线分析结果显示，血浆NT-proBNP鉴别诊断EH并发HF-PEF的灵敏度为88.20%、特异度为97.21%，ROC曲线下AUC值为0.940；E/A值鉴别诊断EH并发HF-PEF的灵敏度为85.41%，特异度为94.39%，ROC曲线下AUC值为0.922；LV鉴别诊断EHMI并发HF-PEF的灵敏度为74.90%，特异度为88.17%，ROC曲线下AUC值为0.827。
结论老年EH伴HF-PEF患者NT-proBNP、LVMI值增大，E/A降低，检测上述三项指标对于诊断HF-PEF有一定的价值。
[关键词]老年；原发性高血压；射血分数保留的心力衰竭；氨基末端脑钠肽前体Changes of plasma NT-proBNP,E/A and LVMI in elderly patients with EH and HF-PEF and their di-agnostic valueWu Xinglei,Jin Ye*Department of Emergency Medicine,Central Hospital of Fengxian District of Shanghai City.Shanghai,201499,P.R.China*Corresponding author：Jin Ye，E-mail：[ABSTRACT]Objective To investigate the changes of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP), maximal peak blood flow in early diastole of mitral valve(peak E)(peak E)/maximal peak blood flow during mitral atrial systole(peak A)and left ventricular mass index(LVMI)in elderly patients with essential hypertension(EH)and heart failure with preserved ejection fraction(HF-PEF)and their significance.Methods90elderly EH patients with HF-PEF diagnosed from March2017to May2019were selected as HF-PEF group,and90simple EH patients were selected as EH group.The plasma NT-proBNP level was detected by ELISA,and the left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),E/A and LVMI were measured by echocardiography.Receiver operating curve(ROC) was used to analyze the value of NT-proBNP,E/A and LVMI in the differential diagnosis of HF-PEF in EH patients.R esults The plasma NT-proBNP level of HF-PEF group was significantly higher than that of EH group,E/A value was lower than that of EH group,LVMI was larger than that of EH group.The above differences between the two groups were statistically significant (<0.05).But there was no significant difference in LVEF and LVEDD between the two groups (>0.05).ROC curve analysis results showed that the sensitivity of plasma NT-proBNP in differential diagnosis of EH with HF-PEF was88.20%,the specificity was97.21%,the AUC value under ROC curve was0.940;the sensitivity of E/A value in differentialdiagnosis of EH with HF-PEF was85.41%,the specificity was94.39%,and the AUC value under the ROC curve was0.922;the sensitivity of LV differential diagnosis of EHMI with HF-PEF was74.90%,the specificity was88.17%,and the AUC value under the ROC curve was0.827.Conclusion The NT-proBNP and LVMI increased and E/A decreased in elderly EH patients with HF-PEF.The detection of the above three indexes has a certain value in the diagnosis of HF-PEF.[KEYWORDS]elderly;essential hypertension;heart failure with preserved ejection fraction;amino terminal brain natriuretic peptide precursor部分慢性心力衰竭患者表现出左室射血分数(leftventricular eject fraction,LVEF)呈下降趋势或正常，通信作者：金叶，电子信箱：177但伴有着组织充血或运动耐受降低等症状，也被称为保留射血分数心衰（heart failure with preserved ejection fraction,HF-PEF）患者[1-2]，HF-PEF其发病率约占心力衰竭总数的50％[3]。
Assessment value of echocardiogram combined with serum hs-CRP and NT-proBNP levels on cardiac function of patients with coronary heart failure/Lu Fengjin, Li Xin, Li Meng, Cheng Guojie Department of Cardiology, Beijing Daxing District People’s Hospital, Beijing 102600, China Corresponding author: [Abstract] Objective: T o explore the assessment value of echocardiogram combined with serum high-sensitivity C-reactive protein (hs CRP) and N-terminal pro brain natriuretic peptide (NT proBNP) levels on cardiac function of patients with coronary heart failure. Methods: A total of 306 patients with coronary heart failure admitted to Beijing Daxing District People's Hospital from November 2021 to November 2022 were selected as the study group. Among of them, 144 cases were grade II, 103 cases were grade III and 59 cases were grade IV as the classification of New Y ork Heart Association (NYHA) for cardiac function. A total of 108 healthy examinees who underwent physical examinations in our hospital during the same period were selected as the healthy control group. All examinees were classified as the NYHA for cardiac function, and left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF), peak ejection rate (PER) and peak filling rate (PFR) of them were measured by echocardiogram. The NT proBNP and hs CRP levels of all examinees were measured. Receiver operating characteristic (ROC) curve was used to analyze the values of single LVEDV , LVESV , LVEF , PER, PFR, hs CRP and NT-proBNP , and the combination of them. Results: LVEDV (122.69±18.24) ml and LVESV (70.79±10.03) ml of the study group were significantly higher than (92.27±15.22) ml and (33.16±7.22) ml of the healthy control group, and the LVEF (42.26±5.13)%, PER (2.49±0.22) EDV/s and PFR (1.79±0.26) EDV/s of the study group were significantly lower than (69.34±5.27)%, (3.56±0.27) EDV/s, and (2.59±0.23) EDV/s of the healthy control group, with statistical significances (t =15.526, 35.837, 46.828, 40.825, 28.302, P <0.05), respectively. [摘要] 目的：探讨超声心动图联合血清高敏C反应蛋白(hs-CRP)、N末端B型钠尿肽前体(NT-proBNP)水平对冠心病心衰患者心功能的评估价值。
血浆N-末端脑钠肽前体水平检测对不同类型心力衰竭的诊断价值刘永祥;李素萍【摘要】目的探讨血浆N-末端脑钠肽前体(NT-proBNP)水平与心力衰竭类型及NYHA心功能分级之间的关系.方法根据患者临床表现、超声心动图检查结果,将136例心力衰竭患者分为全心衰竭(Ⅰ组)、左心衰竭(Ⅱ组)、右心衰竭(Ⅲ组)三组;根据NYHA心功能分级标准,将每组患者分为两个亚组:全心衰竭NYHA分级Ⅲ级(ⅠA)组、全心衰竭NYHA分级Ⅳ级(ⅠB)组;左心衰竭NYHA分级Ⅲ级(ⅡA)组、左心衰竭NYHA分级Ⅳ级(ⅡB)组;右心衰竭NYHA分级Ⅲ级(ⅢA)组、右心衰竭NYHA分级Ⅳ级(ⅢB)组.选择38例同期因心脏病住院的非心力衰竭患者为对照组.入院后48小时内行超声心动图检查,24小时内检测血浆NT-proBNP水平.结果血浆NT-proBNP水平在心力衰竭组明显高于对照组(P<0.05),ⅠB组明显高于ⅠA 组(P<0.05),ⅡB组明显高于ⅡA组(P<0.05),ⅢA组与ⅢB组比较无显著性差异(P>0.05).在同一心功能分级下,血浆NT-proBNP水平在全心衰竭组与左心衰竭组比较无显著性差异(P>0.05),而全心衰竭组、左心衰竭组与右心衰竭组比较,均存在显著性差异(P<0.01).血浆NT-proBNP水平与LVEF的相关性:在全心衰竭组患者呈负相关(r=-0.465,P=0.02),左心衰竭组呈负相关(r=-0.725,P=0.001),右心衰竭组无相关性(r=-0.126,P=0.398).结论心力衰竭患者血浆NT-proBNP水平升高,但与患者心力衰竭的类型、临床心功能分级(NYHA分级)、左室射血分数存在相关性.全心衰竭、左心衰竭患者血浆NT-proBNP水平与NYHA心功能分级相关、且明显高于右心衰竭者,但二者比较无显著性差异;右心衰竭患者,不同NYHA心功能分级患者血浆NT-proBNP水平无差异.在全心衰竭和左心衰竭患者,血浆NT-proBNP水平与LVEF呈负相关,而在右心衰竭患者,血浆NT-proBNP水平与LVEF 无相关性.【期刊名称】《泰山医学院学报》【年(卷),期】2013(034)011【总页数】5页(P811-815)【关键词】血浆N-末端脑钠肽前体;心力衰竭;诊断【作者】刘永祥;李素萍【作者单位】泰安市第一人民医院内二科,山东,泰安,271000;泰安煤矿疗养院药剂科,山东,泰安,271000【正文语种】中文【中图分类】R541.6脑钠素是一种心脏神经激素，是心室功能障碍的敏感指标。
氨基末端脑利钠肽前体在预测慢性肾脏病心血管疾病中的研究
进展
朱星宇;谢席胜
【期刊名称】《临床医学进展》
【年(卷),期】2024(14)5
【摘要】慢性肾脏病(CKD)的全球患病率一直呈现较高的趋势,疾病负担严重。
心血管疾病(CVD)是CKD的等危症,也是CKD患者死亡的主要原因。
通过对CKD患者早期预测及干预可降低CKD患者的死亡率并改善预后。
氨基末端脑利钠肽前体(NT-proBNP)和B型脑钠肽(BNP)是诊断心力衰竭(HF)患者的标志物也与CKD关系密切。
本文重点综述了NT-proBNP及BNP对CKD患者发生CVD的预测及风险分层方面的作用。
【总页数】11页(P1194-1204)
【作者】朱星宇;谢席胜
【作者单位】川北医学院附属南充市中心医院肾内科南充
【正文语种】中文
【中图分类】R69
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NT-pro BNP 对心力衰竭患者疗效及预后评估价值赵慧慧;许丁【摘要】目的：探讨血浆氨基末端脑利钠肽前体（NT-proBNP）下降率对慢性心力衰竭（CHF）患者疗效及预后的评估价值。
方法：心功能分级为 IV 级的 CHF患者120例，根据入院时以及治疗好转出院时 NT-proBNP 水平下降率分组。
其中 A 组68例，NT-proBNP 水平下降率≥30%，B 组52例，NT-proBNP 水平下降率＜30%。
观察两组患者疗效，对比两组患者出院后3个月、6个月、12个月内不良心脏事件发生率以及再住院率。
结果：A 组治疗总有效率为88.24%，B 组治疗总有效率为71.15%，差异有统计学意义（P ＜0.05）；A 组出院后3个月、6个月、12个月内不良心脏事件的发生率分别为5.88%、8.82%、11.76%，B 组分别为5.77%、17.31%、32.69%，A 组出院后3个月、6个月、12个月内再住院率为4.41%、5.88%、8.82%，B 组分别为5.77%、19.23%、26.92%，两组患者出院后12个月内心血管不良事件发生率、再住院率差异有统计学意义（P ＜0.05）；A 组治疗后 LVEF、LVFS、LVESVI、6MWT 等指标改善明显优于 B 组，比较差异有统计学意义（P<0.01）。
结论：NT-proBNP 水平下降率能够对 CHF 患者疗效及预后进行评估，NT-proBNP 水平下降率低于30%患者预后较差。
【期刊名称】《现代仪器与医疗》【年(卷),期】2015(000)005【总页数】3页(P101-102,107)【关键词】血浆氨基末端脑利钠肽前体;慢性心力衰竭;疗效;预后【作者】赵慧慧;许丁【作者单位】北京市平谷区医院心内科，北京101200;北京市平谷区医院心内科，北京 101200【正文语种】中文【中图分类】R541.6慢性心力衰竭（chronic heart failure，CHF）属于大部分心血管疾病进展最终结果，CHF患者预后较差，心血管事件不良发生率、再住院率以及死亡率均较高[1-2]。
龙源期刊网
NT-proBNP与早期心力衰竭超声心动图指标的相关性
作者：张建国唐烨晖
来源：《中国当代医药》2012年第14期
[摘要] 目的探讨血浆N末端B型利钠肽原（N-terminal pro-B-type natriuretic peptide， NT-proBNP）对早期心力衰竭患者的预告与超声心动图指标的相关性。
方法将无心力衰竭症状（心力衰竭A、B期）心血管病住院患者按血浆NT-proBNP水平分为高NT-proBNP组80例，低NT-proBNP对照组78例，利用超声心动图测定每组患者的左室舒张末内径（LVEDD）、
左房内径（LAD）、左室射血分数（LVEF），二尖瓣舒张早期流速峰值（E峰），二尖瓣舒张晚期流速峰值（A峰）和E/A比值，E峰下降时间（EDT）及左室等容舒张时间（IVRT），对结果进行统计学处理。
结果高NT-proBNP组与对照组LAD、LVEDD、LVEF、EDT、IVRT、E/A差异有统计学意义（P ＜ 0.01），NT-proBNP与LAD、LVEDD、EDT、IVRT呈
正相关（分别为r = 0.683、0.325、0.563、0.664，均为P ＜ 0.01），与LVEF、E/A呈负相关（分别为r = -0.432、-0.643，均为P ＜ 0.01）。
结论临床上对心力衰竭A、B期的患者进行
血浆NT-proBNP测定，并结合超声心动图指标有助于心力衰竭早期的预告和诊断。
[关键词] B型利钠肽；N末端B型利钠肽原；心力衰竭；超声心动图；生物标记物
[中图分类号] R541.6[文献标识码] A[文章编号] 1674-4721（2012）05（b）-0005-02。
血浆脑钠肽前体与慢性心衰的相关性分析邹宗武【期刊名称】《安徽医学》【年(卷),期】2012(033)011【摘要】目的比较不同分级的慢性心衰患者血浆中NT-proBNP水平的差异,并分析其相关性.方法选取诊断明确的慢性心衰患者114例,按NYHA分级为I-II级41例,III级53例,IV级20例,并选取老年健康体检者50例为对照组,记录并比较各组NT-proBNP,LVEF,LV Dd,分析其与心衰分级及其他临床指标的相关性.结果经单因素分析,对照组及心功能分级不同组之间的NT-proBNP浓度、LVEF、LV Dd具有明显差异,NT-proBNP(F=46.85,P<0.05),LVEF(F=152.85,P<0.05)、LVDd(F=69.71,P<0.05)与心衰具有相关性.多因素Logistic回归分析,NT-proBNP的Wald值最高,预测作用最强,是诊断心衰的敏感指标.经Spearman相关性分析,血清NT-proBNP水平与心衰分级呈正相关性(r=0.86,P<0.05).NT-proBNP表达水平与LVEF呈负相关性(r=-0.583,P<0.05),而其与LVDd呈正相关性(r=0.845,P<0.05).结论 NT-proBNP检测具有灵敏、准确的特点,相比心功能分级能更客观、动态地反映心功能状况,对心力衰竭的临床诊断和治疗具有重要意义.【总页数】2页(P1506-1507)【作者】邹宗武【作者单位】242200,广德县人民医院内三科【正文语种】中文【相关文献】1.心力衰竭患者N端脑钠肽前体血浆前体血浆浓度水平与超声心动图的相关性分析 [J], 左继岩;茶春喜;罗仁;杨胜祥;杜晓强;陈劢;姚建平;艾克拜尔;梁田2.慢性心衰患者氨基末端脑钠肽前体、血浆肌钙蛋白Ⅰ、高敏C反应蛋白的变化情况分析 [J], 尤洪帅3.慢性心衰患者氨基末端脑钠肽前体、血浆肌钙蛋白Ⅰ、高敏C反应蛋白的变化情况分析 [J], 尤洪帅;4.慢性心衰患者血浆脑钠肽前体N端片段测定的价值 [J], 杜来景;董平栓;杨旭明;杨喜山;王绍欣;陈胜江;闫鹏;孙宗立5.全程中医特色健康指导对慢性心衰患者血浆脑钠肽前体及心力贮备的影响 [J], 嵇克刚;徐庆会;施翔因版权原因，仅展示原文概要，查看原文内容请购买。
超声心动图和 N末端脑利钠肽前体对心力衰竭的诊断及预后的价值分析【摘要】目的：采用超声心动图和N末端脑利钠肽前体（NT-proBNP)的诊断方法对患有心脏病以及心力衰竭的患者进行诊断效果得到临床验证效果较好，本文对上述两种方法结合后在预后临床价值进行评估分析。
方法：选用2017年4月到2019年8月来院治疗的68例患者作为分析对象，比较分析不同患者的N末端脑利钠肽前体（NT-proBNP)与超声心动图显示的心脏结构异常的相关性，对预后情况进行评估。
根据临床资料、心脏超声心动图、年龄等条件分为对两个年龄组，中青年组≦75岁，平均年龄（48.22±4.99)岁，老年组均≧75岁，平均年龄（78.25±6.36）岁，两组患者住院治疗原因均为心力衰竭，心衰原因包括冠心病、高血压、瓣膜病。
所有患者均在入院时进行过超声心动图检查。
确诊为心力衰竭。
对两组患者进行NT-ProBNP水平的测定，对老年组心力衰竭患者进行随访，观察评估诊断和预后价值，观察住院及死亡等事件。
结果：两组患者N末端脑利钠肽前体（NT-proBNP)水平比较有显著差异(P<0.01),老年心力衰竭者根据随访发现住院及死亡事件的水平显著高于中青年组。
对比差异有统计学意义（P<0.05）。
结论:NT-ProBNP检测对老年心力衰竭的诊断以及鉴别评估的临床意义较大，具有推广价值。
【关键词】超声心动图;NT-proBNP;心力衰竭The value of echocardiography and N-terminal pro brain natriuretic peptide in the diagnosis and prognosis of heart failurePeople's Hospital of Donghai County, Jiangsu Province, Zuo Jiyan, Sun Runfeng(Corresponding author)222300[Abstract] Objective: echocardiography and N-terminal pro-brain natriuretic peptide (NT proBNP) were used to diagnose the patientswith heart disease and heart failure, which was proved to be effective in clinical practice. In this paper, after the combination of the two methods, the clinical value of prognosis was evaluated and analyzed. Methods: 68 patients who were treated in our hospital from April 2017to August 2019 were selected as the objects of analysis. Thecorrelation between N-terminal pro BNP and echocardiographic cardiac structural abnormality in different patients was compared and analyzed, and the prognosis was evaluated. According to the clinical data, echocardiography, age and other conditions, the patients were pidedinto two age groups:young and middle-aged group ≤ 75 years old, average age (48.22 ± 4.99) years old, old group ≥ 75 years old, average age (78.25 ± 6.36) years old. The causes of heart failure in both groups were heart failure, including coronary heart disease, hypertension, valve disease. All patients underwent echocardiographyat the time of admission. Heart failure was diagnosed. The NT proBNP level was measured in the two groups, and the elderly patients with heart failure were followed up to observe and evaluate the value of diagnosis and prognosis, and to observe the events of hospitalization and death. Results: there was a significant difference in the level of NT proBNP between the two groups (P < 0.01). The difference was statistically significant (P < 0.05). Conclusion: NT proBNP detectionis of great clinical significance in the diagnosis and differential evaluation of heart failure in the elderly, and it is worth popularizing.[Key words] echocardiography; NT proBNP; heart failure心力衰竭是超过65岁老年人中主要的、常见病症，大约有5%~10%的患者患有心力衰竭。
