老年急性呼吸困难患者脑利钠肽测定结果分析

Plasma B-type Natriuretic Peptide in Elderly with Acute Dyspnea

目的探讨老年急性呼吸困难患者血浆脑利钠肽(BNP)水平对临床诊断的意义及对心功能不全的诊断价值。方法选择老年(>65岁)急性呼吸困难患者95例,其中心源性呼吸困难患者73例,肺源性呼吸困难患者22例。应用快速床旁试验方法测定血浆BNP水平,确定血浆BNP界值。结果心功能不全所致的急性呼吸困难患者血浆BNP水平明显升高,与肺源性呼吸困难患者比较有统计学意义(P<0.05)。血浆BNP诊断界值在150 pg/mL时其特异性及敏感性均达85%左右,曲线下面积(AUC)为0.869。心源性呼吸困难组合并肾功能异常患者,其诊断界值在225 pg/mL。结论血浆BNP对于老年急性心源性呼吸困难患者有诊断价值,其诊断界值为150 pg/mL。

Objective To explore the role of plasma B-type natriuretic peptide（BNP）levels in elderly pts with acute dyspnea and determined the optimum cut- off values for elderly pts with heart failure （HF）. Methods Ninety - five elderly （〉65 years, 73 pts with heart failure,22 pts with pulmonary diseases） were enrolled in the study. Plasma BNP concentration was measured with immu- nofluorescence assay. Results BNP levels in pts with heart failure were significantly higher than that in pts with pulmonary diseases （P〈0.05）. The optimum cut off values was 150 pg/mL, sensitivity and specificity was 85 0% and area under curve（ AUC） was 0. 869. The cut - off values in pts with heart failure and renal dysfunction （225 pg/mL） was higher than that in pts with normal renal function. Conclusion Plasma BNP level might be a quantitative index for diagnosis of elderly pts with HF and acute dyspnea. The optimum cut - off values was 150 pg/mL.