血浆B型尿钠肽水平在临床诊疗中的运用

Application of plasma B-type natriuretic peptide in the clinical diagnosis and therapy

目的探讨血浆B型尿钠肽(BNP)水平在临床心力衰竭及呼吸困难诊疗中的意义。方法采用深圳瑞莱SSJ-2型多功能免疫检测仪,测定65例老年心力衰竭患者(NYHAⅡ、Ⅲ、Ⅳ)、50例同期住院治疗非心力衰竭患者及抗心力衰竭治疗后部分患者的血浆BNP的水平;另分别检测8例心源性呼吸困难和3例肺源性呼吸困难患者的血浆BNP水平。比较各组血浆BNP水平,以及治疗前、后血浆BNP水平的变化情况。结果心力衰竭患者血浆BNP水平显著高于对照组(P<0.01);治疗后心力衰竭患者BNP水平明显下降(P<0.01);心源性、肺源性呼吸困难患者血浆BNP水平比较,差异有统计学意义。结论血浆BNP水平检测可用于心力衰竭患者NYHA诊断及辅助分级,作为心力衰竭患者疗效观察的指标,同时,可对急性呼吸困难进行鉴别。

Objective To investigate the significance of plasma B-type natriuretic peptide（BNP） in the clinical diagnosis and therapy of heart failure and dyspnea. Methods 65 cases of elderly patients with heart failure （NYHA Ⅱ, Ⅲ, Ⅳ）, 50 cases of healthy controls（control group）,8 cases of patients with cardiac dyspnea and 3 cases of patients with pulmonary dyspnea were en- rolled and determined for the plasma BNP level by using SSJ-2 multifunctional immune detector（RUI-LAI, Shenzhen）. Patients with heart failure were determined before and after treatment. Plasma BNP levels of each group, and plasma BNP levels of patients group with heart failure before and after treatment were compared. Results Plasma BNP level of patients with heart failure was signifi- cantly higher than control group（P〈0.01）. Plasma BNP level of patients with heart failure significantly decreased after treatment （P〈0.01）. There was statistical difference of plasma BNP level between patients with cardiac or pulmonary dyspnea. Conclusion Plasma BNP level could be used for the NYHA diagnosis and classification of the patients with heart failure, for the judgment of curative effect in patients with heart failure and for the differential diagnosis of acute dyspnea.