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目的:探讨B型利钠肽(BNP)在鉴别心源性呼吸困难和肺源性呼吸困难并进行危险度分层及预后评估方面的价值。方法:168例急性呼吸困难患者分为心源性呼吸困难组(A组)112例和肺源性呼吸困难组(B组)56例,A组分左室射血分数(LVEF)≥40%(A_1)和LVEF<40%(A_2)两亚组,B组分右心功能不全(B,)和非右心功能不全(B_2)两亚组,并按28 d内存活与否分为死亡组与存活组,比较各组间的BNP值。结果:A组的BNP值显著高于B组(P<0.01),且A_2组的BNP值显著高于A_1亚组(P<0.01);B_1组BNP水平明显高于B_2组(P<0.05);A组中死亡组BNP值高于其余三组(全部P<0.01)。结论:BNP为辨别心源性呼吸困难和肺源性呼吸困难的可靠指标,并可进行病情严重度分层和预测短期病死率。
Objective: To investigate the value of B-type natriuretic peptide (BNP) in differentiating cardiogenic dyspnea and pulmonary-derived dyspnea from risk stratification and prognosis. Methods: One hundred and seventy-eight patients with acute dyspnea were divided into cardiogenic dyspnea group (group A), 112 cases and pulmonary-derived dyspnea group (group B), 56 cases. Part A left ventricular ejection fraction (LVEF) (A_1) and LVEF <40% (A_2) two subgroups, B component right ventricular dysfunction (B) and non-right ventricular insufficiency (B_2) subgroups and were divided into two groups according to their survival within 28 days Group and survival group, comparing BNP values between groups. Results BNP in group A was significantly higher than that in group B (P <0.01), and BNP in group A_2 was significantly higher than that in group A_1 (P <0.01). The BNP level in group B_1 was significantly higher than that in group B_2 (P <0.05) ; BNP in death group A was higher than the other three groups (all P <0.01). CONCLUSION: BNP is a reliable indicator of cardiogenic dyspnea and pulmonary-derived dyspnea, and stratifies the severity of illness and predicts short-term mortality.