目的　 探讨B型脑钠肽（B-type natriuretic peptide, BNP）、心肌肌钙蛋白-I（Cardiac troponin-I, cTn-I）、尿酸（Uric acid, UA）和前白蛋白（Prealbumin, PA）在慢性心力衰竭（CHF）的诊断和疗效观察中合理应用技巧。 方法　分别测定CHF患者血浆中BNP、cTn-I水平和血清中UA、PA水平，并与对照组比较；分析抗心衰治疗7天后4项指标的变化；观察UA、PA的变化与BNP、cTn-I变化之间的相关性。　结果　 CHF患者BNP、cTn-I、UA水平较对照组均有所升高（t值分别为91.660、28.738、16.325，P均<0.001），PA较对照组有所下降（t=11.371,P<0.001），均有统计学意义；抗心衰治疗后，BNP、cTn-I、UA较治疗前均有下降（t值分别为12.512、5.104、3.907，P均<0.001），而PA有所上升（t=4.270,P<0.001），均有统计学意义；UA变化与BNP变化呈正相关关系（r=0.617, P＜0.001）,随BNP的升高而升高；PA变化与BNP变化呈负相关关系（r=-0.421, P＜0.001），随BNP的升高而降低；PA变化与cTn-I变化呈负相关关系（r=-0.301, P＜0.001）,随着cTn-I的升高而降低；UA则与cTn-I无相关关系（P>0.05）。 结论 　BNP、cTn-I、UA、PA在CHF的诊断和疗效观察中均有很好的应用价值；UA、PA在对CHF患者进行疗效判断时可作为较好的观察指标，对BNP能够起到一定的替代作用。

Objective To explore the reasonable application of BNP, cTn-I, UA and PA in the diagnosis and observation of curative effect in patients with chronic heart failure (CHF). Methods The concentration of BNP, cTn-I in plasma and UA, PA in serum in patients with CHF and healthy controls were detected. The changes of these markers pre-therapy and post-7-days-treatment were analyzed. Results The levels of BNP, cTn-I and UA in CHF patients were significantly higher than that of healthy controls (P<0.001), while the level of PA was significantly lower than controls（P<0.001）. The levels of BNP, cTn-I and UA went down significantly after 7-days effective treatment (P<0.001）, and the level of PA went up（P<0.001）.The change of UA was positively correlated with the change of BNP (r=0.617, P＜0.001), and the change of PA was negatively correlated with the change of BNP（r=-0.421, P＜0.001）.The change of PA was negatively correlated with cTn-I（r=-0.301, P＜0.001）, while the change of UA had no correlation with cTn-I（P>0.05）. Conclusion The BNP, cTn-I, UA and PA have good application value in the diagnosis and the observation of curative effect in CHF. The UA and PA could be served as better observation targets in the diagnosis and judgment of curative effect in CHF; they can substitute BNP to a certain degree.