血浆NT-proBNP对急性呼吸困难鉴别意义

Significance of Plasma NT-proBNP in Identification of Acute Dyspnea Patients

目的探讨N末端脑钠肽前体（NT-proBNP）对心源性呼吸困难和肺源性呼吸困难的鉴别价值。方法选择2010年3月～2011年12月住院的呼吸困难患者88例，根据呼吸困难的病因不同，分为心源性组和肺源性组，同时选择健康体检者40名为正常对照组，检测三组血浆NT-proBNP水平，采用超声心动图检测心肺两组患者的左室射血分数、左室舒张末内径、左房舒张末内径。结果心源性组NT-proBNP水平与肺源性组比较，差异有统计学意义（P〈0．05），心源性组、肺源性组NT-proBNP水平分别与对照组比较，差异均有统计学意义（均P〈0．05）。心源性组左室射血分数和肺源性组比较，差异有统计学意义（P〈0．05）。结论NT-proBNP可作为鉴别心源性呼吸困难和肺源性呼吸困难的一个客观指标，较BNP稳定、可靠，同样可广泛应用于心衰的诊断和危险分层。

Objective To investigate the value of NT-proBNP in the differential diagnosis of dyspnea caused by heart disease or pulmonary disease.Methods 88 cases of patients with dyspnea were selected from March 2010 to December 2011 according to the cause of dyspnea,the patients were divided into cardiogenic group and pulmonary group.40 healthy cases were selected simultaneously.The levels of NT-proBNP in three groups were detected,and left ventricular ejection fraction were detected by echocardiography in cardiogenic group and pulmonary group.Results The level of NT-proBNP in cardiogenic group compared with pulmonary group,there was a significant difference（P 〈 0.05）;the level of NT-proBNP in card!ogenic group and pulmonary group compared with control group respectively, there were significant differences（all P 〈 0.05）;the left ventricular ejection fraction in cardiogenic group compared with pulmonary group,there was a significant difference（P 〈 0.05）.Conclusion NT-proBNP can be used as an objective indicator to identify cardiac dyspnea and pulmonary breathing difficulties,compared with BNP, stable and reliable;the same can be widely used in the diagnosis and risk stratification of heart failure.