论文部分内容阅读
目的探讨血浆脑钠肽(BNP)在鉴别心源性呼吸困难和肺源性呼吸困难的临床价值。方法急诊科收治的急性呼吸困难患者63例,其中心源性呼吸困难36例(A组),肺源性呼吸困难27例(B组),同期健康体检者21例(C组)。采用酶联免疫吸附法快速检测血浆BNP水平,同时测定A、B两组入院时的左室射血分数(LVEF),比较3组患者血浆BNP的差别及BNP与LVEF之间的关系。结果 163例患者中诊断为心源性呼吸困难组36例BNP均值为(616.4±36.8)pg/ml,27例诊为肺源性呼吸困难组BNP均值为(87.6±34.2)pg/ml,心源性呼吸困难组血浆BNP含量显著高于肺源性呼吸困难组,2组比较差异有统计学意义(P<0.01);2以100pg/ml为阈值诊断心力衰竭的价值最高,其准确率、灵敏度、特异性分别为94%、90%、95%;3心源性呼吸困难组BNP与LVEF成负相关(r=-0.72,P<0.05)。结论快速检测血浆BNP对鉴别急性心源性及肺源性呼吸困难有重要临床价值,可作为心力衰竭的诊断指标。
Objective To investigate the clinical value of plasma brain natriuretic peptide (BNP) in differentiating cardiogenic dyspnea and pulmonary-derived dyspnea. Methods A total of 63 patients with acute dyspnea admitted to the emergency department were enrolled in this study. Among them, 36 were group A with heart-based dyspnea (group A), 27 with pulmonary-type dyspnea (group B) and 21 with group C (healthy subjects). Plasma BNP levels were measured by enzyme-linked immunosorbent assay (ELISA). Left ventricular ejection fraction (LVEF) at admission was measured in groups A and B. Plasma BNP levels and BNP levels were compared between the two groups. Results The mean of BNP in 36 patients diagnosed as cardiogenic dyspnea was (616.4 ± 36.8) pg / ml in 163 patients, and (87.6 ± 34.2) pg / ml in 27 patients diagnosed as pulmonary dyspnea. Plasma BNP levels in patients with dyspnea were significantly higher than those in patients with pulmonary dyspnea (P <0.01). 2 The value of 100 pg / ml was the highest in diagnosing heart failure. The accuracy, Sensitivity and specificity were 94%, 90% and 95%, respectively. BNP was negatively correlated with LVEF in cardiogenic dyspnea group (r = -0.72, P <0.05). Conclusion Rapid detection of plasma BNP has important clinical value in differential diagnosis of acute cardiogenic and pulmonary dyspnea and can be used as a diagnostic indicator of heart failure.