| Objective:To observe the response of serum NT-proBNP in heart failure(HF)and other diseases[acute cerebral infarction(ACI),acute myocardial infarction(AMI),renal failure(RF)],so as to explore the difference and clinical significance of serum NT-proBNP in these diseases.Methods:A total of 200 outpatients and inpatients(50 cases with HF;50 cases with ACI;50 cases with AMI;50 cases with RF)in our hospital from January 2018 to January 2019 were collected.The correlation between serum NT-proBNP and these diseases in each group was further analyzed.The HF group was divided into three groups according to the ejection fraction(HFpEF(EF? 50%),HPmrEF(ejection fraction between 40%?49%)and HPrEF(EF<40%).The serum NT-proBNP concentrations of patients in each group were observed.The correlation between ejection fraction and serum NT-proBNP concentration was analyzed.According to the size of cerebral infarction,the patients were divided into two groups:large cerebral infarction group and non-large cerebral infarction group.The correlation between serum NT-proBNP concentration and cerebral infarction area was observed.The myocardial infarction group was divided into left ventricular infarction group and right ventricular infarction group according to the location of vascular involvement,to explore the difference of serum NT-proBNP in the increased concentration of left and right ventricular infarction,so as to analyze the correlation between serum NT-proBNP and troponin I between the two groups.The RF group was divided into simple RF group and RF with HF group according to whether they were complicated with HF.The difference of serum NT-proBNP concentration between the two groups was observed to analyze the correlation between serum creatinine and serum NT-proBNP.Results:The results of HF group showed that the lower the ejection fraction,the more obvious the increase of serum NT-proBNP,and there was a significant negative correlation among the three groups(r=-0.866,P<0.01).There was a significant difference in serum NT-proBNP concentration among the three groups(P<0.05).The results of the study in patients with ACI showed that the increase of serum NT-proBNP in patients with cerebral infarction was closely related to the size of cerebral infarction.The larger the infarction area,the higher the serum NT-proBNP(P<0.05).In patients with AMI,the increased concentration of NT-proBNP in left ventricular ST segment elevation myocardial infarction was significantly higher than that in right ventricular ST segment elevation myocardial infarction(P<0.05).There was no significant correlation between NT-proBNP and troponin I concentrations(P=0.897,P>0.01).In RF group,it was found that NT-proBNP concentrations in patients with RF complicated with HF was significantly higher than that of patients with simple RF(P<0.05).There was a positive correlation between serum creatinine and serum NT-proBNP in patients with simple renal failure(r=0.427,P=0.029,P<0.05),but there was no significant correlation between serum creatinine and serum NT-proBNP in patients with RF complicated with HF(P=0.069,P>0.05).Through the comparison among these groups,it was found that there was no significant difference in the increase of serum NT-proBNP between ACI and AMI(P=0.469,P>0.05).The serum NT-proBNP concentrations in other groups was significantly higher than that in AMI group and ACI group(P<0.05).The serum NT-proBNP concentrations in patients with simple RF was significantly higher than that in patients with HF(P<0.05).When RF patients complicated with HF,the serum NT-proBNP concentration was also significantly higher than that in patients with simple RF(P<0.05).Conclusion:Increased NT-proBNP is often used in the diagnosis of all kinds of cardiac insufficiency,as well as the diagnosis and treatment evaluation of HF,which has gradually become the general consensus of many experts and clinicians."The Guidelines for Diagnosis of Heart Failure(2018)" pointed out that the increase of NT-proBNP can be used as class I,A diagnostic index for the diagnosis of HF,which is enough to see the importance of serum NT-proBNP in the clinical diagnosis of HF.However,in clinical work,there are many factors that cause the increase of NT-proBNP.The results of this study show that relying solely on serum NT-proBNP concentration as an index for the diagnosis of HF may be too unreliable.In View of the large number of groups in this study,the small sample size and the wide fluctuation range of data,the reliability of the conclusion may decrease and the sample size needs to be further expanded.However,the data of each group will still give us a good reference,reminding clinicians that they should better understand all kinds of diseases that may cause the increase of NT-proBNP.Increased NT-proBNP has important clinical reference value for the diagnosis of many diseases,and reasonable application of this diagnostic index can avoid the delayed diagnosis or misdiagnosis of various diseases as far as possible. |
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