贵州医科大学学报

2018, v.43;No.214(07) 837-840

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两种血浆N-末端脑钠肽前体检测方法对心源性或肺源性急性呼吸困难的鉴别诊断
Clinical Value of Nt-pro BNP Detection in Differentiating Acute Dyspnea

梅蕊;张茜;薛忠文;
MEI Rui;ZHANG Qian;XUE Zhongwen;Department of Emergency,Beijing 401 Hospital of China Nuclear Industry;Heart Center,Beijing Chaoyang Hospital Affiliated to Capital Medical University;Department of Cardiology Medicine,Liangxiang Hospital in Fangshan District;

摘要(Abstract):

目的:探讨两种血浆N-末端脑钠肽前体(Nt-proBnp)检测方法对心源性或肺源性急性呼吸困难的鉴别诊断价值。方法:200例急性呼吸困难患者分为心源性组(心源性急性呼吸困难,n=107)和肺源性组(肺源性急性呼吸困难,n=93),50例同期体检健康者作为对照组,分别采用干式免疫层析法、双抗体夹心法检测3组受试者入院或体检时血浆Nt-proBnp水平;比较2组急性呼吸困难患者入院时的左心室射血分数(LVEF)及血浆Nt-proBnp水平,同时观察心源性呼吸困难患者NYHA心功能分级与血浆Nt-proBnp水平的关系。结果:2种方法检测的血浆Nt-proBnp结果显示,3组被检者各组内比较,差异无统计学意义(P>0.05);2组急性呼吸困难患者血浆Nt-proBnp水平明显高于对照组(P<0.05),心源性组显著高于肺源性组(P<0.05);入院时,心源性组患者LEVF水平较肺源性组患者明显降低(P<0.05),心源性组急性呼吸困难患者血浆Nt-proBnp>550 ng/L的比例明显高于肺源性组(P<0.05),而Nt-proBnp<120 ng/L的比例明显低于肺源性组(P<0.05);随着心功能等级的升高(Ⅰ级~Ⅳ级),心源性急性呼吸困难患者血浆Nt-proBnp水平呈升高趋势,差异有统计学意义(P<0.05)。结论:2种血浆Nt-proBnp检测方法均能有效鉴别心源性或肺源性呼吸困难,血浆Nt-proBnp水平与左心室功能改变、心功能分级密切有关。
Objective: To explore the clinical value of plasma Nt-proBnp detection in different types of acute respiratory dyspnea. Methods: 200 patients with acute dyspnea were divided into the cardiogenic group( with cardiac acute dyspnea,n = 107) and the pulmonary group( with pulmonary acute dyspnea,n = 93),and 50 healthy subjects were collected as the control group. Nt-proBNP levels of plasma and left ventricular ejection fraction( LVEF) of the 3 groups were compared. The nt-probnp level of patients with different cardiac functions was assessed. The distribution of Nt-proBNP concentration was analyzed. Results: The plasma concentration of Nt-proBnp in patients with cardiogenic acute dyspnea was significantly higher than that in patients with lung diseases( P < 0. 05). Patients with a history of myocardial infarction were more likely to suffer from cardiogenic acute dyspnea( P < 0. 05).The level of Nt-proBnp in patients with cardiogenic acute dyspnea was significantly higher than that in patients with pulmonary artery( P < 0. 05). The level of Nt-proBNP was negatively correlated with left ventricular ejection fraction( LVEF). The difference of Nt-proBNP levels in pateients with variedheart function of cardiogenic dyspnea were significant( P < 0. 05). When Nt-proBnp > 550 pg/m L,the number of patients in the cardiogenic group was significantly larger than that in the patients with pulmonary heart failure( P < 0. 05). When Nt-proBNP < 120 pg/m L,the number of patients with cardiogenic dyspnea was significantly smaller than that in patients with pulmonary heart failure( P < 0. 05).Conclusion: Plasma Nt-proBNP analysis can effectively identify cardiogenic and pulmonary dyspnea.

关键词(KeyWords): 呼吸困难,急性;呼吸困难,阵发性;N-末端脑钠肽前体;左心室射血分数;实验室
respiratory dyspnea,acute;respiratory dyspnea,paroxysmal;N-terminal pro-B-type natriuretic peptide;left ventricular ejection fraction;laboratory

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基金项目(Foundation): 首都卫生发展科研专项项目(首发2014-4-7071)

作者(Author): 梅蕊;张茜;薛忠文;
MEI Rui;ZHANG Qian;XUE Zhongwen;Department of Emergency,Beijing 401 Hospital of China Nuclear Industry;Heart Center,Beijing Chaoyang Hospital Affiliated to Capital Medical University;Department of Cardiology Medicine,Liangxiang Hospital in Fangshan District;

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DOI: 10.19367/j.cnki.1000-2707.2018.07.021

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