床旁快速检测BNP鉴别急性呼吸困难的临床意义

Clinical Significance of Rapid Bedside Measurement of Plasma B Type Natriuretic Peptide in Differential Diagnosis Acute Dyspnea.

目的:评价床旁快速测定B型钠尿肽(BNP)对呼吸困难患者的鉴别诊断价值。方法:荧光免疫法测定64例以急性呼吸困难为主诉的住院患者血浆BNP水平。结果:①心源性呼吸困难患者血浆BNP水平明显高于非心源性呼吸困难患者[(803±457)pg/ml与(72±34)pg/ml,P<0.01];②BNP≥100pg/ml诊断充血性心力衰竭(CHF)的敏感性为92.7%,特异性为91.4%,阳性预测值为90.8%,阴性预测值为93.1%;③BNP水平与NYHA心功能分级呈正相关(P<0.01)。结论:快速测定BNP有助于鉴别心源性呼吸困难与非心源性呼吸困难。

Objective To evaluate the differential diagnostic value of rapid bedside measurement of plasma B type natriuretie peptide （BNP） in patient with acute dyspnea. Methods Plasma BNP levels were measured with FIA in 64 patients hospitalized with acute dyspnea. ReSults （1） Plasma BNP levels in patients with cardiac dyspnea were higher than those in patients with non -cardiac dyspnea [ （803 ±457）pg/ml vs （72 ±34）pg/ml, P 〈0.01 ]. （2） In cases with plasma BNP levels 〉 100pg/ml, the diagnostic sensi- tivity, specificity, positive and negative predictive values for heart failure were 92.7%, 91.4%, 90.8% and 93.1% respectively. （3） BNP levels were significantly positively correlated with NYHA grading （ P 〈 0.01 ）. Conclusion Rapid measurement of BNP is useful for differential diagnosis of dyspnea.