氨基末端脑钠肽前体鉴别心源性和非心源性呼吸困难的临床分析

Clinical analysis of N terminal pro brain natriuretic peptide for differentiate cardiac and non cardiac dyspnea

目的探讨氨基末端脑钠肽前体(NT-proBNP)在急诊呼吸困难中的鉴别诊断价值。方法160例急性呼吸困难患者按心功能分为心力衰竭组86例和非心力衰竭组74例,50例健康体检查为健康对照组,观察比较各组的血浆NT-proBNP浓度。结果心力衰竭组引起呼吸困难患者NT-proBNP浓度明显高于非心力衰竭组患者(P<0.01),非心力衰竭组显著高于健康对照组(P<0.05);心力衰竭组NT-proBNP浓度在心功能不同分级及不同年龄患者之间差异有统计学意义(P<0.01),与左室射血分数呈负相关(P<0.01)。结论床边快速测定血浆NT-proBNP水平对急诊以呼吸困难为主要表现的心力衰竭病因鉴别诊断和处理具有较高的应用价值。

Objective To investigate the value of N terminal pro brain natriuretic peptide（NT-pro BNP） for differentiates dyspnea in emergence case.Methods 160 patients with acute dyspnea were classified as heart failure group（86 cases） and non heart failure group（74 cases） by the standard of cardiac function,50 health volunteers as control group.Serum NT-pro BNP of the three groups was compared.Results The NT-pro BNP level in heart failure group was significantly higher than non heart failure group（P0.01）,and NT-pro BNP level in non heart failure group was higher than control group（P0.05）.The level of NT-pro BNP in heart failure group has statistical difference in different cardiac function and different age（P0.01）,meanwhile it has a negative correlation with left ventricular ejection fraction（P0.01）.Conclusion Bedside test of plasma NT-pro BNP level is helpful for diagnosis and treatment of patients with chief compliant of acute dyspnea.