氨基末端B型利钠肽前体测定对急性呼吸困难诊断价值的探讨

The diagnostic value of amino-terminal pro-B-type natriuretic peptide (NT-proBNP) test in patients presenting with acute dyspnea

目的探讨氨基末端B型利钠肽前体(NT-proBNP)对急性呼吸困难的诊断价值。方法将464例急性呼吸困难患者,根据临床资料及心脏超声心动图分为急性充血性心力衰竭组(急性心衰组)及非心衰组,测定并比较两组患者NT-proBNP的水平,评价其对急性呼吸困难鉴别诊断的价值。结果急性心衰组243例,非心衰组221例,NT-proBNP分别为(2484.4±102.5)pg/ml和(248.6±9.5)pg/ml,两组比较具有显著性差异(P<0.001)。以NT-proBNP≥3849pg/ml为阳性,诊断急性充血性心力衰竭的灵敏度为92.6%,特异度为86.3%。结论急诊常规检测NT-proBNP有利于对急性呼吸困难患者做出快速诊断,有助于鉴别急性呼吸困难是否为急性充血性心力衰竭所致。

Objective To study the diagnostic value of amino -terminal pro -B -type natriuretic peptide （NT-proBNP） test in patients presenting with acute dyspnea. Methods A total of 464 dyspneic patients as evaluated in the Department of Emergency. According to the clinical characteristic and echocardiography results, patients were divided into acute congestive heart failure group （ACHF） and non-ACHF group. NT-proBNP levels were tested in all patients. Results There were 243 ACHF patients and 221 Non-ACHF patients, and NT-proBNP levels were significantly different between the two groups [（2484.4±102.5）pg/ml vs. （248.6±9.5）pg/ml, P 0.001]. Conclusions Routine NT-proBNP test in Department of Emergency is useful to triage quickly for those patients with acute dyspnea. It is very useful in determing patients with acute congestive heart failure.