摘要
目的探讨N-末端脑钠肽(Nt-ProBNP)在鉴别心源性和非心源性呼吸困难的临床价值,特别是鉴别舒张性心力衰竭(DHF)与慢性阻塞肺疾病(COPD)的价值。方法比较分析明确诊断的96例急性呼吸困难患者中心源性呼吸困难患者(56例)和非心源性呼吸困难患者(40例)的Nt-ProBNP水平,同时对25例DHF和28例COPD急性发作期的Nt-ProBNP、心脏彩超的左室射血分数(LVEF)、二尖瓣舒张早晚期流速峰值比(E/A)、E峰减速时间(DT),收缩期肺动脉压(SPAP)、肺功能(FEV1)进行分析比较。结果心源性呼吸困难患者Nt-ProBNP水平明显高于非心源性呼吸困难组[(4121.05±3326.24)pg/mlvs(729.16±524.06)pg/ml,P<0.01];DHF患者Nt-ProBNP水平明显高于COPD亚组[(3853.97±2125.05)pg/mlvs(514.67±428)pg/ml,P<0.01]。结论测Nt-ProBNP简便、快捷,可作为鉴别急性呼吸困难患者有临床价值的观察指标。特别对老年多发的、常见的、临床又难以判断的COPD与DHF的诊断有一定指导意义。
Objective To explore N-terminal Pro-BNP （Nt-proBNP） in the differential diagnosis of cardiogenic and non-cardiogenic dyspnea,especially in diastolic heart failure （DHF） and chronic obstructive pulmonary disease （COPD）.Methods Ninety-six cases were divided into two groups （56 cases of cardiogenic dyspnea and 40 cases of non-cardiogenic dyspnea） and comparatively analyzed,including 25 cases of DHF and 28 cases of COPD.Nt-proBNP,left ventricular ejection fraction （LVEF） by echocardiography,the ratio of peak early filling velocity to late filling velocity （E/A）,E wave deceleration time（DTE）,systolic pulmonary artery pressure （SPAP） and forced expiratory volume in one second （FEV1） of the above 25 cases of DHF and 28 cases of COPD in acute episode were comparatively analyzed.Results Nt-proBNP in cardiogenic dyspnea patients was significantly higher than that in non-cardiogenic dyspnea patients [（4121.05±3326.24） pg/ml vs （729.16±524.06） pg/ml,P0.01],while Nt-proBNP in DHT patients was significantly higher than that in COPD patients [（3853.97±2125.05） pg/ml vs （514.67±428） pg/ml,P0.01].Conclusion This study shows that Nt-proBNP could be used as an observation criterion of the differential diagnosis of dyspnea for its convenience and fast efficacy,especially used in the differential diagnosis of DHF and COPD of the aged.
出处
《实用医院临床杂志》
2010年第6期63-65,共3页
Practical Journal of Clinical Medicine
