Research Progress on Influencing Factors of NT-proBNP in the Diagnosis of Heart Failure

作者：皓珺 张 · 发表于：Advances in Clinical Medicine · 年份：2026 · DOI：10.12677/acm.2026.1682828 · 研究领域：Heart Failure Treatment and Management、Neurological Disease Mechanisms and Treatments、GDF15 and Related Biomarkers

心力衰竭(heart failure, HF)是多种心血管疾病的终末阶段，其高患病率与高再住院率使早期诊断与精准风险评估尤为关键。N末端B型利钠肽原(NT-proBNP)因具有较高灵敏度和良好稳定性，已成为心衰诊断与预后评估的核心生物标志物。然而，其循环水平受多种非心衰因素影响，易导致假阳性或假阴性，从而干扰临床决策。本文系统综述了NT-proBNP的生物学特性及其在不同病理生理状态下的变化机制，多角度讨论NT-proBNP的临床应用需突破单一固定阈值模式，结合患者个体特征及多维临床信息进行综合判断。未来应进一步完善特殊人群的分层诊断界值，并结合机器学习与多模态数据整合，推动心衰诊疗向精准医学方向发展。同时，本文进一步结合多重影响因素叠加的模拟临床场景，提出NT-proBNP判读应遵循“先评估验前概率、再识别干扰方向、继而结合动态变化和超声心动图/其他生物标志物验证”的综合决策路径。Heart failure (HF) represents the terminal stage of various cardiovascular diseases. Its high prevalence and readmission rates make early diagnosis and accurate risk assessment particularly crucial. N-terminal pro-B-type natriuretic peptide (NT-proBNP), characterized by high sensitivity and favorable stability, has emerged as a core biomarker for the diagnosis and prognostic assessment of heart failure. Nevertheless, its circulating levels are not specific to heart failure; instead, they are affected by a variety of non-cardiac factors, which tend to induce false-positive or false-negative results and thus impede clinical decision-making. This article systematically reviews the biological characteristics of NT-proBNP and its variation mechanisms under different pathophysiological conditions. From multiple perspectives, it addresses that the clinical application of NT-proBNP necessitates moving beyond the single fixed threshold paradigm, and comprehensive judgments should be made by integrating patients’ individual characteristics and multidimensional clinical information. Future studies...