The diagnostic role of N-terminal brain natriuretic peptide in identifying acute pulmonary thromboembolism versus congestive heart failure in dyspnea patients
10.3760/cma.j.issn.0254-9026.2018.04.010
- VernacularTitle:N-末端脑钠肽前体在老年人肺血栓栓塞症和心力衰竭中的应用价值
- Author:
Mingjie LIU
1
;
Xianming QIU
;
Qi CAO
;
Dezhi LI
;
Ling ZHU
Author Information
1. 山东大学附属省立医院呼吸内科
- Keywords:
Pulmonary embolism;
Heart failure;
Natriuretic peptide,brain
- From:
Chinese Journal of Geriatrics
2018;37(4):401-404
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the role of NT-proBNP in the differentiation of acute pulmonary embolism (APE) from congestive heart failure (CHF) in patients with acute dyspnea.Methods Consecutive 260 patients aged ≥ 60 years complaining of acute dyspnea were collected between June 2010 and October 2015.The patients were divided into two groups of APE and CHF according to their diagnosis standards.The levels of NT-proBNP between the two groups were compared using t test,and receiver operating characteristic curve (ROC curve) was made to show the value of NT-proBNP in differentiation of APE from CHF.Results Patients in APE group had significantly lower median levels of NT-proBNP as compared with patients in CHF group [(2 478.8±1 473.9)ng/L vs.(5 955.4±3 180.1)ng/L,t =-12.020,P ＜ 0.01].The ROC curve of APE existence against serum levels of NT-proBNP showed an optimal cut-point of NT-proBNP of 1 518 ng/L,with specificity up to 98.8％,and the area under the ROC curve for NT-proBNP was 0.877.Conclusions NT-proBNP as a simple and bedside approach to identify APE versus CHF patients with acute dyspnea can help clinicians identify APE early and reduce the rates of misdiagnosis and missed diagnosis of APE.But the confirmative diagnosis of APE is still based on spiral CT angiography.
