血浆脑钠肽检测对急诊呼吸困难鉴别诊断的应用价值

Value of brain natriuretic peptide in differential diagnosis of dyspnea in emergency department

目的评价快速测定脑钠肽（BNP）对急诊呼吸困难病因的鉴别诊断价值。方法测定76例以呼吸困难为主诉在急诊科就诊和急诊入院患者血浆BNP水平，以2位不知道BNP结果的心血管专家根据患者的临床资料作出的诊断为标准，评价BNP水平对以呼吸困难为主诉的患者诊断充血性心力衰竭（CHF）的敏感性和特异性。结果BNP≥100pg／ml诊断CHF的敏感性为95．1％，特异性为97．1％，阳性预测值为97．5％，阴性预测值为94．4％。BNP水平与心力衰竭的严重程度相关。结论急诊快速测定BNP有助于鉴别心源性与非心源性呼吸困难。

Objective Evaluation rapid determination of brain natriuretic peptide （BNP） for emergency difficulty breathing causes of the differential diagnosis value. Methods Plasma BNP levels were measured in 76 patients with chief complaint of dyspnea in emergency department. Clinical diagnosis of each patient was made by two cardiologists who were blind to BNP levels and only reviewed the elinieal data was regarded as standard diagnosis, the sensitivity and speeifieity of BNP levels in diagnosis of CHF in patients with dyspnea were ealculated. Results At a cutpoint of 100 pg/ml, BNP had the following decision statistics： sensitivity 95.1%, specificity 97.1%, positive predictive value 97.5%, negative predictive value 94.4%, BNP levels and the severity of the heart failure related. Conclusion Rapid test of BNP in the emergency department axe useful to tell cardiac etiologies from other etiologies of dyspnea.