血浆N-末端脑钠肽前体质量浓度对急性呼吸困难的诊断意义(1)
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[摘要] 目的:探讨血浆N-末端脑钠肽前体(NT-proBNP)质量浓度变化在急性心源性呼吸困难诊断和鉴别诊断中的临床意义。方法：选取以呼吸困难为主诉来我院急诊的患者110例,分为心源性呼吸困难组64例和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质量浓度。结果：心源性呼吸困难组与非心源性呼吸困难组血浆NT-proBNP质量浓度分别为(3 641.48±2 931.53)ng•L-1和(565.83±301.53)ng•L-1,两组间比较差异有统计学意义(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质量浓度比较差异有统计学意义(P<0.01),心功能分级越差,NT-proBNP质量浓度越高；以NT-proBNP质量浓度600 ng•L-1作为临界值,血浆NT-proBNP质量浓度对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用来诊断心力衰竭特别是左心衰的方法可靠、稳定、敏感、快捷,可作为鉴别急性呼吸困难病因的一个重要检查方法。
[关键词] 血浆N-末端脑钠肽前体； 心力衰竭； 呼吸困难
[中图分类号] R441.8; R563.8 [文献标识码] A [文章编号] 1671-7256(2011)02-0197-03
doi：10.3969/j.issn.1671-7256.2011.02.024
Value of plasma NT-proBNP levels in diagnosing and differentiating
in acute dyspnea patients
ZHOU Bin, WAN Shao-bing, WANG Ying
(Department of Emergency, the Third Hospital of Wuhan City, Hubei 430060, China)
[Abstract] Objective:To investigate the clinical value of the plasma NT-proBNP levels in patients with acute cardiac dyspnea or noncardiac dyspnea. Methods： 110 patients with acute dyspnea were divided into two groups: cardiac dyspnea group(64 cases) and noncardiac dyspnea group(32 cases). The plasma NT-proBNP level was measured by enzyme-linked immunosorbent assay(ELISA). Results: The plasma NT-proBNP level of the cases with cardiac dyspnea and non cardiacdyspnea was(3641.48±2931.53)ng•L-1 and (565.83±301.53)ng•L-1 respectively with a significant difference(P<0.01). The plasma NT-proBNP level in the cases with different classes of the NYHA heart function was also significantly different(P<0.01), and the worse heart function, the higher plasma NT-proBNP level was. If 600 ng•L-1 was taken as a critical value, the plasma NT-proBNP level was excellently sensitive for diagnosing cardiac dyspnea(93.75%), but the specificity was not very good(69.56%). Conclusion： The plasma NT-proBNP level is highly sensitive for diagnosing cardiac dyspnea and differentiating with noncardiac dyspnea, which works in a convenient rapid way in clinic.
[Key words] NT-proBNP； heart failure； dyspnea ......
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