Value of N-terminal Pro-brain Natriuretic Peptide and Uric Acid in Differential Diagnosis of Acute Pulmonary Thromboembolism and Congestive Heart Failure
ZHOU Hong-li, ZHONG Sheng-nian, BAO Hai-yong
Affiliated Hospital of Qinghai University emergency center EICU,Qinghai Xining 810001
Abstract：【Objective】To investigate the value of N-terminal pro-brain natriuretic peptide (NT-proBNP) and uric acid in the differential diagnosis of acute pulmonary thromboembolism (APE) and congestive heart failure (CHF). 【Methods】 A total of 93 APE patients and 167 CHF patients admitted to our hospital were selected. Then the NT-proBNP levels were measured by electrochemiluminescence immunoassay, meanwhile the uric acid levels were analyzed by an automated biochemical analyzer. Thereafter, the differences in the levels of the two indicators between APE and CHF was analyzed, and the ROC curve was explored the differential diagnosis value for APE and CHF. 【Results】The levels of NT-proBNP and uric acid in patients with APE were significantly lower than those in CHF group, the difference was statistically significant (P<0.05). The AUC of NT-proBNP was 0.893, the AUC of uric acid was 0.762, and the AUC of NT-proBNP combined with uric acid was 0.924. Different truncation points were selected to evaluate the application in APE. If NT-proBNP =1799.0 pg/mL combined with uric acid =281.0 μmol/L, the APE sensitivity and specificity were 21.3% and 98.9% respectively. If NT-proBNP=5981.0 pg/mL parallel uric acid=569.0 μmol/L the APE sensitivity was 99.3% and the specificity was 19.6%. 【Conclusion】NT-proBNP and uric acid can be used as reliable and sensitive indicators to apply differential diagnosis of APE and CHF,which have high clinical application value.
[1] 焦红见, 张永海, 陶玲,等. 慢性充血性心力衰竭患者血浆中性粒细胞明胶酶相关脂质运载蛋白与N-末端B型脑钠肽前体的相关性[J].中国老年学杂志, 2016, 36(15):3675-3676.
[2] Yuan JL, Xue-Jun DU, Wang J, et al. Quantitative Detection of N-terminal Brain Natriuretic Peptide in the Diagnosis of Heart Failure[J].Guide of China Medicine,2017,36(14):1076-1079.
[3] Radwan H, Gomaa A. Does N-terminal pro-brain natriuretic peptide level predict prognosis of acute pulmonary embolism[J].Atherosclerosis Supplements,2017, 25:e5.
[4] Nicola M, Josè V, Matteo GP, et al. Accuracy of Nurse-Performed Lung Ultrasound in Patients With Acute Dyspnea:A Prospective Observational Study[J].Medicine,2016, 95(9):e2925.
[5] 葛均波, 徐永健. 内科学.第8版[M]. 北京:人民卫生出版社, 2013.
[6] 谭宇峰. 血清肌钙蛋白I和N末端B型脑钠肽前体联合检测在充血性心力衰竭患者预后及危险分层中的作用[J].中外医学研究, 2016, 14(5):62-64.
[7] Ibrahim I, Kuan W S, Frampton C, et al. Superior performance of N-terminal pro brain natriuretic peptide for diagnosis of acute decompensated heart failure in an Asian compared with a Western setting[J].Eur J Heart Failure,2017, 19(2):209.
[8] Ersoy A O, Ozler S, Oztas E, et al. The Association between N-terminal Pro-Brain Natriuretic Peptide Levels in the Umbilical Vein and Amniotic Fluid Volume Abnormalities[J].Rev Bras Gynecol Obstet,2016, 38(04):177-182.
[9] Amna M, Abdel KA, Mohammad NF, et al. Brain Natriuretic Peptide in Liver Cirrhosis and Fatty Liver: Correlation with Cardiac Performance:[J].Electronic Physician,2016, 8(2):1984-1993.
2020, Vol. 37 
