脑钠素测定在急性哮喘病因鉴别诊断中的应用价值

THE APPLICATION VALUE OF DETECTING BRAIN NATRIURETIC PEPTIDE IN IDENTIFING THE DIFFERENT CAUSE OF ACUTE ASTHMA

目的评价脑钠素(BNP)测定对急诊急性哮喘性呼吸困难病因鉴别诊断的价值。方法选择我院2004年4月—2007年10月哮喘性呼吸困难住院患者79例,根据病因分为心源性哮喘组(48例);肺源性哮喘组(31例)和正常对照组(30例),采用ELISA法测定三组血浆BNP水平。结果心源性哮喘组血浆BNP浓度[(534.7±305.2)ng/L]显著高于肺源性哮喘组[(75.4±53.7)ng/L],二组比较差异有统计学意义(P<0.001);以正常对照组的血浆BNP浓度的(-x±s1.96S)为标淮,诊断充血性心衰(CHF)的敏感性为96%,特异性为93%。结论血浆BNP是诊断CHF较好的血液指标,尤其对于鉴别哮喘性呼吸困难患者是否为心源性哮喘或肺源性哮喘具有重要意义。

Objective To investigate the application value of brain natriuretic peptide （BNP） determination in identifying different cause of acute asthma. Methods 79 patients with acute asthma in emergency room of our hospital were divided into cardiac asthma group （48 cases） and pulmonary asthma group （31 cases） . Normal control group was 30 cases. ELISA method was used to detect plasma BNP levels. Results BNP concentration of cardiac asthma plasma group [（534.7 ± 305.2） ng/ L] was significantly higher than that of pulmonary asthma group [（75. 4 ±53.7） ng/ L] （P 〈0.001）. According to the plasma BNP concentration of normal control group, sensitivity of congestive heart failure （CHF） diagnosis was 96%. Specificity of CHF diagnosis was 93%. Conclusion The level of BNP is a better indicator for diagnosing CHF. especially for identificating the different cause of acute asthma.