N末端B型利钠肽原对急性呼吸困难的鉴别诊断价值

Differential diagnostic value of N-terminal pro-B type natriuretic peptide for acute dyspnea

目的:探讨血清N末端B型利钠肽原(NT-proBNP)水平对急性呼吸困难患者鉴别诊断的价值。方法:以胶体金法检测66例充血性心力衰竭(CHF)患者(CHF组)和38例有急性呼吸困难表现的非CHF患者(非CHF组)的血清NT-proBNP浓度,并与30例健康成人(正常对照组)作比较。结果:(1)CHF组NT-proBNP水平显著高于非CHF组和正常对照组[(2856.5±384.5)ng/L比(175.6±38.8)ng/L比(159.3±30.4)ng/L,P<0.01];(2)CHF组NT-proBNP水平随NYHA心功能等级(Ⅱ,Ⅲ,Ⅳ级)的升高而显著升高[(2428.8±286.9)ng/L比(2815.6±318.8)ng/L比(3268.8±426.6)ng/L,P<0.01];(3)Spearman相关分析显示,NT-proBNP与NYHA分级呈正相关(r=0.795,P<0.01),与左心室射血分数呈负相关(r=-0.745,P<0.01)。结论:血清N末端B型利钠肽原水平对呼吸困难的鉴别诊断具有重要临床价值。

Objective： To explore differential diagnostic value of serum level of N-terminal pro-B type natriuretic peptide （NT-proBNP） on patients with acute dyspnea. Methods： Colloidal gold method was used to measure serum concentration of NT-proBNP in 66 patients with congestive heart failure （CHF, CHF group） and 38 non CHF patients presenting acute dyspnea （non CHF group）. The results of above patients were compared with that of 30 healthy adults （normal control group）. Results： （1） Compared with non CHF group and normal control group, there was significant increase in NT-proBNP level [ （175.6 ± 38. 8） ng/L vs. （159.3 ± 30.4） ng/L vs. （2856. 5 ± 384. 5） ng/L, P 〈0.01] in CHF group; （2） There was significant increase in NT-proBNP level [（2428. 8 ± 286.9） ng/L vs. （2815.6 ± 318.8） ng/L vs. （3268.8± 426. 6） ng/L, P（0.01] along with increase of NYHA cardiac function class Ⅱ , Ⅲ and Ⅳ; （3） Spearman correlation analysis indicated that NT-proBNP level was positively correlated with NYHA class （r = 0. 795, P〈0.01）, and negatively correlated with left ventricular ejection fraction （r = -0. 745, P〈 0.01）. Conclusion： Serum level of N terminal pro-B type natriuretic peptide possesses important clinical value for differential diagnosis of dyspnea.