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目的研究NT-proBNP截断值(cut-off值)水平在鉴别急性左心衰竭和急性右心衰竭中的价值.方法 纳入78例明确存在急性心衰的患者作为实验组,根据其类型不同进一步分为左心衰组(A组,44例)以及右心衰组(B组,34例),并选取健康成人40例作为对照组.分别测定参与者的NT-proBNP水平,分析三组数据间的差异,然后绘制出受试者工作特征曲线(ROC曲线),并找到鉴别这两种不同类型心衰的最佳临界值.结果两实验组数据差距具有统计学意义(P<0.01).对照组明显小于两实验组,其差异有统计学意义(P<0.01).分析受试者工作特征曲线,其鉴别两组实验组的最佳截断点(cut-off值)为3 000 ng/L.结论 血清NT-proBNP可作为鉴别急性左右心衰的一个实用有效客观的临床实验室指标.“,”Objective To explore the significance of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) in distinguishing patients with acute left-sided heart failure (ALHF) from those with acute right-sided heart failure (ARHF). Methods Periheral venous blood samples were collected during the first 24 hours after admission from 44 patients with ALHF, 34 patients with ARHF, and 40 healthy people (control group) to detect the serum NT-proBNP level. Receiver operating characteristic curve (ROC curve) was drawn so as to find the best cut-off value for diagnosis of ALF. .Results The serum NT-proBNP level of the ALHF group was(13,120±8,571.87)ng/L, significantly higher than that of the ARHF group [( 3,419.76±3,531.68)ng/L, P<0.01]. The serum NT-proBNP levels of the ALHF and ARHF groups were both significantly higher than that of the control group [(65.7±34.14)ng/L, P<0.01]. When the figure 3000 ng/L was selected as the cutoff value of NT-proBNP in diagnosing ALF, the sensitivity was 95% and the specificity was 86%. Conclusion Serum NT-proBNP level successfully serves as a practical, effective, and objective clinical laboratory marker in differentiating ALF from ARF.