关键词: 呼吸困难, 氨基末端B型脑钠肽前体, 肌钙蛋白I, 心型脂肪酸结合蛋白

Abstract: AIM: To explore the differential diagnostic and prognostic values of measurements of N-terminal pro-brain natriuretic peptide(NT-proBNP), cardiac troponin I(cTnI)and heart-type fatty acid-binding protein(H-FABP) in patients with dyspnea.METHODS: Choice 80 patients [55 males and 25 females; mean age (53.5±7.8) years] with dyspnea as test group and 20 healthy persons [14 males and 6 females; mean age (52.6±6.9) years] as control group, and the serum concentrations of NT-proBNP, cTnI and H-FABP were detected, patients with dyspnea were divided into one group of chronic systolic heart failure (CHF) and the other group of non chronic systolic heart failure (NCHF) according to the hospital discharge diagnosis, the CHF group was divided into three subgroups of cardiac function II, III, IV according to the New York Heart Association (NYHA) standard. NT-proBNP, cTnI and H-FABP levels were observed and compared in the five groups. Patients were followed up to be observed the recurrence of cardiac events.RESULTS: The concentration of NT-proBNP, cTnI, H-FABP in the CHF group were higher than those in the control group and NCHF group (P<0.05), the cardiac function was worse with the increase of concentration (P<0.05), while there was no significant difference between the control and NCHF group (P>0.05). The sensitivity of NT-proBNP, cTnI, H-FABP three combined detection in the diagnosis of CHF was 93.6%, and the negative predictive value was 95.6%,which was higher than that of NT-proBNP, cTnI, H-FABP of any single detection, the difference was statistically significant (P<0.05). In the follow-up patients of the cardiac events group, serum NT-proBNP, cTnI and H-FABP concentrations at hospital discharge were markedly higher than those in the non-cardiac events group (P<0.01).CONCLUSION: There is important significance on diagnosis, prognosis and judging the severity for the detection of NT-proBNP, cTnI and H-FABP in patients with CHF.The levels of NT-proBNP, cTnI and H-FABP can possibly be used clinically in differentiating dyspnea of CHF from NCHF.

Key words: dyspnea, N-terminal pro-brain natriuretic peptide, cardiac troponin I, heart-type fatty acid binding protein