作者：张方芳，雷向仰，章可霞，庄文洪

单位：

515031 广东省汕头市中医医院 广州中医药大学附属汕头医院超声科

Units：

Department of Ultrasound，Shantou Hospital of Traditional Chinese Medicine/Shantou Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine，Shantou 515031，China

关键词：

心力衰竭；心脏超声；N 末端脑钠肽前体；诊断

Keywords：

Heart failure；Cardiac ultrasound；N-terminal brain natriuretic peptide precursor；Diagnosis

CLC：

DOI：

10.12114/j.issn.1008-5971.2021.00.018

Funds：

摘要：

背景　因心力衰竭患者的临床症状缺乏特异性，需结合生物学标志物提高疾病诊断率，N 末端脑钠肽前体（NT-proBNP）多用于评估心力衰竭患者预后，其在疾病诊断中的相关报道较少。目的　探讨心脏超声联合血清NT-proBNP 水平对慢性心力衰竭的诊断价值。方法　回顾性选取汕头市中医医院 2018 年 3 月—2019 年 5 月收治的慢性心力衰竭患者 72 例为研究组，另选取同期本院收治的非慢性心力衰竭患者 32 例为对照组。比较两组心脏超声检测指标及血清 NT-proBNP 水平。结果　研究组患者左心房内径、左心室舒张末期内径大于对照组，左心室射血分数低于对照组（P ＜ 0.05）。研究组患者血清 NT-proBNP 水平高于对照组（P ＜ 0.05）。72 例慢性心力衰竭患者中，根据心脏超声诊断64例，诊断符合率为88.9%（64/72）；根据血清NT-proBNP水平诊断67例，诊断符合率为93.1%（67/72）；根据心脏超声联合血清NT-proBNP水平诊断71例，诊断符合率为98.6%（71/72）。结论　慢性心力衰竭患者心功能降低，血清 NT-proBNP 水平升高，且心脏超声联合血清 NT-proBNP 水平对慢性心力衰竭具有较高的诊断符合率。

Abstract：

Backgroud　Because of the lack of specificity of clinical symptoms in patients with heart failure，it is necessary to combine biological markers to improve the diagnosis rate of the disease. N-terminal pro-brain natriuretic peptide（NT-proBNP） is mostly used to assess the prognosis of patients with heart failure，but its related reports in disease diagnosis are less.Objective　To analyze the diagnostic value of cardiac ultrasound and serum NT-proBNP in patients with chronic heart failure. Methods　From March 2018 to May 2019，72 cases of patients with chronic heart failure in Shantou Hospital of Traditional Chinese Medicine were selected as experimental group，and 32 cases of non chronic heart failure patients were selected as control group in the same period.Test indexes of cardiac ultrasound and serum NT-proBNP level were compared between the two groups.Results　Left atrial diameter and left ventricular end-diastolic diameter in the experimental group were higher than those in the control group，left ventricular ejection fraction in the experimental group was lower than that in the control group（P ＜ 0.05）.Serum NT-proBNP level in the experimental group was higher than that in the control group（P ＜ 0.05）.In 72 cases of chronic heart failure patients，64 cases were diagnosed by cardiac ultrasound，the total diagnostic coincidence rate was 88.9%（64/72）； 67 cases were diagnosed by serum NT-proBNP，the total diagnostic coincidence rate was 93.1%（67/72）；71 cases were diagnosed by cardiac ultrasound combined with serum NT-proBNP，the total diagnostic coincidence rate was 98.6%（71/72）. Conclusion　Cardiac function of patients with chronic heart failure decreased and serum NT-proBNP level in those patients increased. The method of chronic heart failure diagnosed by cardiac ultrasound combined with serum NT-proBNP has high diagnostic coincidence rate.

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