血浆BNP检测在急性呼吸困难原因鉴别中的价值

Role of detecting plasma BNP in identifying the causes of acute dyspnea

目的探讨B型脑钠肽(BNP)检测在急性呼吸困难(AD)病因鉴别中的价值。方法AD患者68例,采用床旁快速免疫分析仪检测血浆BNP值,心脏彩超检测左室射血分数(LVEF)、左室舒张末期容积(LVEDV)、周边短轴缩短率(FS)和心肌酶谱。68例分为LVEF≤50%组(A组,49例)和LVEF>50%组(B组,19例)或血浆BNP>500pg/L组(C组,35例)和血浆BNP<100pg/L组(D组,33例)。以同期健康体检志愿者20名为对照(E)组。结果 A组患者血浆BNP明显高于B组[(6685.9±2666.3)pg/L vs.(3001.5±3583.5)pg/L](P<0.05)。C组FS大于D组[(37.6±2.1)%vs.(31.8±8.0)%](P<0.05)。C组肌酸激酶(CK)高于D组[(158.6±171.3)U/L vs.(80.1±60.7)U/L](P<0.05)。C组肌酸激酶同工酶(CK-MB)高于D组[(23.1±9.3)U/L vs.(15.3±5.6)U/L](P<0.05)。结论检测血浆BNP值对AD患者可以初步鉴别心源性呼吸困难和肺源性呼吸困难,且可以作为心功能评价指标。

Objective To study the role of detecting plasma BNP in identifying the causes ot acute dyspnea（AD）. Methods With bedside rapid immune analyzer and ultrasonography, plasma BNP and cardiac function-related indicators of left ventrieular ejection fraction（LVEF）, left ventricular end diastolic volume（LVEDV）, fraction shortening（FS） and myocardial enzyme spectrum were examined in 68 patients with AD,who were divided into grops of A（LVEF≤50%,49 cases） and B （LVEF〉 50%,19 cases） or groups of C（BNP〉500 pg/L, 35 cases） and D（BNP〈100 pg/L, 33 cases）. Twenty healthy persons were taken as the controls（group E）. Results Plasma level of BNP was higher in group A than that in group BE（6685.9 ± 2666.3） pg/L vs. （3001.5 ± 3583.5） pg/L] （P〈0.05）. FS was higher in group C than that in group DE （ 37.6 ± 2.1 ） % vs. （ 31.8 ± 8.0） %] （P〈0.05）. So did the creatine kinase （CK） E（158. 6 ± 171.3） U/L vs. （80. 1 i 60. 7） U/L] （P〈0. 05） and the CK-MB E（23.1±9.3） U/L vs. （15.3±5.6） U/L]（P〈0. 05）. Conclusion Detection of plasma BNP may preliminarily differentiate cardiac dyspnea from respiratory dyspnea and can be taken as an indicator for evaluating cardiac function.