N末端B型钠尿肽原在妇产科心源性与非心源性呼吸困难的临床鉴别价值

Clinical differential value of NT-proBNP in obstetrics and gynecology cardiac and non cardial dysenea

目的：通过检测妇产科呼吸困难患者血清N末端B型钠尿肽原（NT—proBNP）水平，探讨NT—proBNP在心源性和非心源性呼吸困难的临床鉴别价值。方法：在对妇产科病房69例急性呼吸困难患者临床干预前抽取静脉血。检测血清NT—proBNP，采用电化学发光免疫分析（ECLIA）法。结果：心源性呼吸困难组患者血清NT—proBNP水平显著高于非心源性呼吸困难组患者（P〈0．01），其阳性率也显著高于后者（P〈0．01）。以血清NT—proBNP〉100pg／ml为标准诊断心源性呼吸困难时，敏感度、特异度、阳性预测值及阴性预测值分别为：100％、92．9％、95．4％和100％；据血清NT-proBNP〉130pg／ml为标准诊断心源性呼吸困难时，敏感度、特异度、阳性预测值及阴性预测值均为100％。结论：妇产科心源性呼吸困难患者血清NT—proBNP水平显著高于非心源性呼吸困难患者，血清NT-proBNP可作为鉴别心源性与非心源性呼吸困难的一项观察指标，具有敏感性和特异性高的特点。

Objective ： Through detection of obstetrics and gynecology difficulty breathing patients, the serum levels of NT- proBNP explore source sex heart and non clinical differential value of cardiac dyspnea. Methods ： In maternity wards in 69 patients with acute dyspnea extraction of venous blood before clinical intervention, to detect serum NT-proBNP, by ECLIA method. Results ： Cardiac dyspnea group had a significantly higher serum level of NT-proBNP than patients with non cardiac patients with dyspnea group（P〈0.01）, the positive rate was also significantly higher than the latter（P〈0.01）.According to the serum NT- proBNP〉100pg/ml of standard in the diagnosis of cardiac dyspnea, sensitivity and positive predictive value and negative predictive value and specific degrees, respectively, 100% and 92.9% and 95.4% and 100%.According to the serum NT-proBNP〉130pg/ml for the standard in the diagnosis of cardiac dyspnea, sensitivity and specific degrees and positive predictive value and negative predictive value of 100%. Conclusions ： Obstetrics and gynecology patients with cardiac dyspnea is significantly higher than the level of serum NT-proBNP in patients with cardiac dyspnea, NT-proBNP serum can be used as identification of cardiac and non cardiac dyspnea an observational indexes, has the characteristics of high sensitivity and specificity.