心源性与肺源性呼吸困难患者血浆脑钠肽水平的临床研究

A Research of Plasma Level of Brain Natriuretic Peptide in Patients with Cardiac vs Pulmonary Dyspnea

目的:研究快速检测血浆脑钠肽(Brain natriuretic peptide,BNP)水平对初步鉴别心源性呼吸困难与肺源性呼吸困难的临床价值。方法:选择有呼吸困难表现的慢性心衰患者249例作为心源性呼吸困难组,按NYHA分级,将其分为NYⅡ、NYⅢ和NYⅣ级3个亚组。选择因单纯肺部疾病引起呼吸困难患者128例作为肺源性呼吸困难组即对照组,并分别测定各组BNP水平和左心室射血分数(LVEF)。比较两组间及不同心功能级别之间的BNP水平及LVEF。结果:BNP水平心源性呼吸困难组显著高于肺源性呼吸困难组,LVEF水平心源性呼吸困难组显著低于肺源性呼吸困难组,差异均有统计学意义(P<0.05),BNP水平随着心功能级别升高而升高,LVEF与BNP水平呈负相关,差异有统计学意义(P<0.05)。结论:BNP可作为初步鉴别心源性呼吸困难与肺源性呼吸困难的一个敏感指标,快速检测血浆BNP水平有较好的临床价值,尤其适用于急诊内科医生。

Objective:To assess effect of plasma brain natriuretic peptide(BNP) by rapid detection on differential diagnosis of patients with cardiagenic and pulmonary dyspnea.Methods:249 patients with dyspnea associated with chronic heart failure(cardiac dypnea group) and 128 patients with dyspnea associated with lung diseases(control group) were collected in this study;and cardiac dypnea group was divided into NYⅡ、NYⅢ and NYⅣ subgroup according to NYHA classification.Plasma level of BNP and left ventricular ejection fraction(LVEF)were measured,and the results were compared between the both groups.Results:Plasma level of BNP in the cardiac dypnea group was higher than that in the control group(P<0.05),but LVEF was the contrary(P<0.05).The level of BNP was higher with increasing cardiac function degree,and LVEF was a negative relation with the BNP(P<0.05).Conclusions:Detection of BNP level is available,because level of BNP may be a sensitive index for differential diagnosis of cardiagenic dypnea or pulmonary dypnea.