BNP对急性呼吸困难患者的应用价值

The Value of Emergent BNP Assay for Differential Diagnosis in Patients Presenting with Dyspnea

目的:通过观察急性呼吸困难患者的血浆B型钠尿肽(BNP)含量变化,探讨BNP在急性呼吸困难患者确定或排除心力衰竭中的诊断价值。方法:收集2006年1月～2007年12月来本院急诊室就诊的急性呼吸困难患者(236人)的资料,分成心源性呼吸困难组和肺源性呼吸困难组进行整理、统计和分析。结果:①心源性呼吸困难组BNP含量426.1(75.9～687.0)ng/L,显著高于肺源性呼吸困难组BNP含量47.2(22.1～101.2)ng/L(P<0.01)。②由受试者工作特征曲线(ROC)分析显示,BNP在ROC曲线下面积为0.854,95%的可信区间为0.806～0.884;确定诊断临界值(cut-off)为100ng/L;敏感度80.5%,特异度79.3%,正确诊断指数为0.66。结论:BNP可作为急性呼吸困难患者的常规检查项目,便于快速确定心源性或肺源性呼吸困难,及时采取治疗措施。

Objective To study the diagnostic value of emergent BNP assay in differentiating heart failure from pulmonary disease in patients presenting with respiratory difficulty, Methods This is a retrospective study on the emergent serum BNP levels upon arrival of patients in 236 patients presenting with dyspnea diagnosis was later fully established after admission. Of these patients, 154 were suffered from cardiac failure and 82 were suffered from pulmonary diseases. Results ①cardiac dyspnea group： BNP concentration 426.1 （75.9±687.0） ng/L which were significantly higher than those in pulmonary dyspnea group （ BNP contents 47.2 （22. 1-101.2） ng/L （P 〈0.01 ）.②Furthur characterstic ROC curve analysis showed that the area under curve is 0.854, The diagnosis cut - off value was determined to be 100ng/L, with sensitivity of 80.5% and specificity 79.3% and the correct diagnosis index 0.66. Conclusion Rapid BNP assay can be used in patients with acute breathing difficulties fof quickly identifing cardiac or pulmonary respiratory difficulties, to take timely measures to treatment.