血浆 N-末端脑钠肽前体水平对急性呼吸困难的诊断意义

摘要

目的：：探讨血浆 N-末端脑钠肽前体(NT-proBNP)水平变化在急性心源性呼吸困难与非心源性呼吸困难患者中诊断和鉴别诊断的临床意义。方法：选取以呼吸困难为主诉来某院急诊的患者110例,分为心源性呼吸困难组64例,非心源性呼吸困难组46例,采用酶联免疫吸附法(ELISA)检测血浆 NT-proBNP 水平。结果：心源性呼吸困难各亚组与非心源性呼吸困难组血浆 NT-proBNP 水平比较有显著性差异(P <0.01)；心源性呼吸困难组中不同 NYHA 心功能分级的患者血浆 NT-proBNP 水平比较有显著性差异(P <0.01),心功能分级越差,NT-proBNP 水平越高；以 NT-proBNP 水平600ng/L 作为临界值,血浆 NT-proBNP 水平对于心源性呼吸困难诊断的敏感性很高(93.75%),但特异性略差(69.56%)。结论：快速检测血浆 NT-proBNP 用来诊断心源性呼吸困难特别是左心衰可靠、稳定、敏感、快捷,可作为急性呼吸困难病因鉴别的一个重要检查方法。%Objectives:To investigate the clinical value of the changes of NT-proBNP levels to the diagno-sis and differentiation of acute cardiogenic dyspnea or non-cardiacgenic dyspnea.Methods:1 10 patients with dyspnea were divided into two groups:cardiogenic dyspnea group (64 cases)and non-cardiogenic dyspnea group (32 cases).The NT-proBNP level was measured with enzyme-linked immunosorbent assay(ELISA). Results:The NT-proBNP level of the cardiogenic dyspnea group and the non-cardiogenic group was obviously different (P <0.01).in cardiogenic dyspnea group,the NT-proBNP level of patients within different NY-HA classification was also significantly different(P <0.01),and the worse the heart function grading was,the higher the NT-proBNP level was.and 600ng/L was taken as a critical value,the NT-proBNP level was ex-tremely sensitive to the diagnosisof cardiogenic dyspnea(93.75%),but the specificity was not very good(69. 56%).Conclusion:It is reliable,stable sensitive ,quick and convenient to diagnose cardiogenic dyspnea based on NT-proBNP,especially left-side heart failure,it can be taken as an important detection methods to identify acute dyspnea.