NT-proBNP对慢性充血性心力衰竭导致胸腔积液的诊断价值

摘要

目的 检测不同病因导致的胸腔积液中的NT-proBNP,进一步探讨NT-proBNP在充血性心衰性胸腔积液诊断中的价值.方法 选取2009年1月至2011年12月期间于我院行诊断性胸腔穿刺的98例胸腔积液患者,按不同病因分为充血性心衰性胸腔积液34例,恶性肿瘤性胸腔积液13例,肺炎性胸腔积液14例,结核性胸腔积液18例,肝硬化腹水伴胸腔积液10例,肾源性胸腔积液9例.采用ELISIA法测定NT-proBNP.结果 与充血性心衰性胸腔积液比较,其余各组NT-proBNP值均较低,具有统计学意义(P＜0.05).分析NT-proBNP诊断充血性心衰性胸腔积液的ROC曲线,并且选取NT-proBNP 1664.49 pg/ml作为充血性心衰性胸腔积液的诊断截定点,诊断敏感性为97.3％,特异性为98.7％.结论 NT-proBNP可以广泛应用于充血性心力衰竭导致的胸腔积液的诊断中,其特异性和敏感性均较高,且简单快速,费用较低,值得临床推广.%Objective To detect the levels of NT-proBNP in patients with pleural effusions from different causes,and to further explore the value of NT-proBNP in the diagnosis of pleural effusions from congestive heart failure.Methods We selected 98 patients who underwent diagnostic thoracentesis with pleural effusion from January 2009 to December 2011,and measured pleural fluid NT-ProBNP levels in the 98 patients,including 34 cases of congestive heart failure,18 cases of tuberculousis,13 cases of malignancy,14 cases of pneumonia,10 cases of hepatic cirrhosis,9 cases of renal failure by means of ELISA.Results Compared with pleural effusion from congestive heart failure,NT-proBNP levels of other groups were lower,which had a statistically significant difference (P＞0.05).We analyzed ROC curve of NT-proBNP with pleural effusion from congestive heart failure,and selected the cutoff point of pleural fluid NT-ProBNP 1664.49 pg/ml,the test had a sensitivity of 97.3％ and a specificity of 98.7％.Conclusion NT-proBNP can be widely used in pleural effusion from congestive heart failure with high sensitivity and specificity,which is simple,fast and with low cost.Therefore it is worthy of clinical promotion.