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目的观察并探讨联合检测血清B型利钠肽(brain natriuretic peptide,BNP)和肌钙蛋白I(troponin I,Tn I)对急性心力衰竭(acute heart failure,AHF)患者诊断及预后评价的价值。方法选择2015年2月~2016年4月湖州市急救中心收治的AHF患者60例,作为观察组;选取同期健康体检者60例,作为对照组。观察组按照心功能分级(NYHA)分为Ⅲ级组32例和Ⅳ级组28例。利用电化学发光法检测并比较观察组与对照组的BNP和Tn I水平,并比较Ⅲ级组和Ⅳ级组治疗前后BNP和Tn I水平的变化。结果观察组BNP和Tn I分别为(2624.4±378.6)pg/m L和(0.87±0.22)ng/m L,明显高于对照组的(72.4±20.2)pg/m L和(0.13±0.02)ng/m L(P<0.05);Ⅲ级组治疗前BNP和Tn I水平均明显低于Ⅳ级组(P<0.05),治疗后72h,Ⅲ级组与Ⅳ级组BNP和Tn I水平均明显降低,且治疗后Ⅲ级BNP和Tn I水平均显著低于Ⅳ级(P<0.05)。结论 BNP联合Tn I水平检测对AHF辅助诊断和预后评估具有重要作用,有利于指导患者的治疗。
Objective To observe and explore the value of combined detection of serum brain natriuretic peptide (BNP) and troponin I (Tn I) in the diagnosis and prognosis of patients with acute heart failure (AHF). Methods Sixty AHF patients admitted from Huzhou Emergency Center from February 2015 to April 2016 were selected as the observation group and 60 healthy subjects were selected as the control group. The observation group was divided into three groups according to cardiac function classification (NYHA): 32 cases in grade group and 28 cases in grade group. The levels of BNP and Tn I in the observation group and the control group were detected and compared by electrochemiluminescence. The levels of BNP and Tn I before and after treatment were compared between Ⅲ and Ⅳ groups. Results The BNP and Tn I in the observation group were (2624.4 ± 378.6) pg / m L and (0.87 ± 0.22) ng / m L, respectively, significantly higher than those in the control group (72.4 ± 20.2 pg / m L and 0.13 ± 0.02) (P <0.05). The levels of BNP and Tn I in group Ⅲ before treatment were significantly lower than those in group Ⅳ (P <0.05). At 72 h after treatment, the levels of BNP and Tn I in group Ⅲ and group Ⅳ (P <0.05). The levels of BNP and Tn I in grade Ⅲ were significantly lower than those in grade Ⅳ (P <0.05). Conclusion The combination of BNP and Tn I detection plays an important role in the diagnosis and prognosis evaluation of AHF, which is helpful to guide the treatment of patients.