BNP在心源性与肺源性呼吸困难鉴别诊断中的意义

Clinical Significance of Plasma BNP Levels in Differentiating Etiology of Dyspnea

目的探讨脑利钠肽检测在心源性与肺源性呼吸困难鉴别诊断中的临床意义。方法收集我院内科收治的呼吸困难患者487例,其中肺源性256例,心源性231例。采用双抗夹心免疫荧光法测定入选患者血清脑利钠肽水平。结果心源性呼吸困难组患者血清BNP水平明显高于肺源性呼吸困难组患者(P<0.01),心源性呼吸困难患者中,NYHA心功能Ⅱ级组、Ⅲ级组、Ⅳ级组间血清BNP水平比较,差异有显著性(P<0.01),血清BNP水平与LVED呈正相关(r=0.567,P<0.01),与LVEF呈负相关(r=-0.506,P<0.01)。肺源性呼吸困难组不同PaO2患者血清BNP水平比较,差异有显著性(P<0.01)。结论血清BNP水平检测在判断肺源性与心源性的呼吸困难方面具有较好的临床鉴别诊断价值。

Objective To study the clinical significance of the plasma BNP level in differentiating etiology of dyspnea. Methods We enrolled 487 cases of dyspnea in the present study and there were 256 cases of heart failure and 232 cases of pulmonary disease. The plasma BNP level was measured by immunofluorescence assay. Results The serum BNP level was much higher in dyspnea with heart failure than those in dyspnea with pulmonary disease （P〈0.01）. The serum BNP level in dyspnea with heart failure was significantly increased. The serum BNP level had a significantly positive correlation with LVED （r =0.567,P〈0.01） and a negative correlation with LVEF （r =-0.506,P〈0.01）in dyspnea with heart failure. There was a significant difference in the serum BNP level between different PaO2 subgroups （P〈0.01）. Conclusion The serum BNP level is useful in the differential diagnosis of dyspnea with heart failure or pulmonary disease.