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目的评价脑钠素(BNP)测定对急诊急性哮喘性呼吸困难病因鉴别诊断的价值。方法选择我院2004年4月—2007年10月哮喘性呼吸困难住院患者79例,根据病因分为心源性哮喘组(48例);肺源性哮喘组(31例)和正常对照组(30例),采用ELISA法测定三组血浆BNP水平。结果心源性哮喘组血浆BNP浓度[(534.7±305.2)ng/L]显著高于肺源性哮喘组[(75.4±53.7)ng/L],二组比较差异有统计学意义(P<0.001);以正常对照组的血浆BNP浓度的(-x±s1.96S)为标淮,诊断充血性心衰(CHF)的敏感性为96%,特异性为93%。结论血浆BNP是诊断CHF较好的血液指标,尤其对于鉴别哮喘性呼吸困难患者是否为心源性哮喘或肺源性哮喘具有重要意义。
Objective To evaluate the value of BNP determination in the differential diagnosis of acute asthmatic respiratory distress. Methods A total of 79 inpatients with asthma-induced dyspnea from April 2004 to October 2007 in our hospital were enrolled. According to the etiology, they were divided into four groups: cardiogenic asthma group (48 cases), pulmonary asthma group (31 cases) and normal control group 30 cases). Plasma BNP levels were measured by ELISA in three groups. Results The plasma BNP level in the asthmatic group was significantly higher than that in the asthmatic group [(534.7 ± 305.2) ng / L [(75.4 ± 53.7) ng / L], P <0.001 ). The sensitivity and specificity of diagnosing congestive heart failure (CHF) were 96% and 93% respectively in the normal control group with (-x ± s1.96S) of plasma BNP concentration. Conclusion Plasma BNP is a good blood index for the diagnosis of CHF, especially for the identification of patients with asthma dyspnea as cardiogenic asthma or pulmonary-derived asthma is of great significance.