N-端脑利钠肽前体在老年呼吸困难鉴别中的价值

Value of N-terminal pro-brain natriuretic peptide in the differential diagnosis of dyspnea in elderly patients

目的探讨N-端脑利钠肽前体(NT-pro BNP)在鉴别老年心源性呼吸困难和肺源性呼吸困难中的临床价值。方法将76例心源性呼吸困难患者作为观察组,86例肺源性呼吸困难患者作为对照组,通过检测2组NT-pro BNP和左室射血分数(LVEF)并进行比较分析,并对观察组中不同LVEF水平、不同美国纽约心脏病协会(NYHA)心功能分级患,NT-pro BNP水平进行分析。结果观察组NT-pro BNP明显高于对照组,LVEF明显低于对照组(P<0.01);观察组不同NYHA心功能分级患者血浆NT-pro BNP浓度不同,各级之间比较差异有统计学意义(P<0.01)。观察组中LVEF值越低者NT-pro BNP浓度越高,不同LVEF分组NT-pro BNP比较,差异有统计学意义(P<0.01);相关性分析显示,LVEF与NT-pro BNP呈负相关(r=-0.977,P<0.01)。结论 NT-pro BNP是鉴别心源性与肺源性呼吸困难的一种敏感而特异的指标。

Objective To investigate the clinical value of N-terminal pro-brain natriuretic peptide（ NT-pro BNP） in distinguishing cardiac dyspnea from pulmonary dyspnea in elderly patients. Methods Seventy-six patients with cardiac dyspnea were chosen as the observation group,while 86 patients with pulmonary dyspnea were selected as the control group. The levels of NT-pro BNP and left ventricular ejection fraction（ LVEF） were detected and analyzed. In observation group,the level of NT-pro BNP in patients with different levels of LVEF and cardiac function of America New York Heart Association（ NYHA） classification was further analyzed. Results The level of NT-pro BNP in observation group was significantly higher and the level of LVEF was significantly lower than that of control group（ P〈0. 01）. In observation group,the patients with different stages of cardiac function of NYHA classification,showed different plasma concentrations of NTpro BNP（ P〈0. 01）. In observation group,the patients with lower LVEF showed higher plasma concentrations of NT-pro BNP（ P〈0. 01）. In observation group,the level of NT-pro BNP was negatively correlated with LVEF（ r =- 0. 977,P〈0. 01）. Conclusions NT-pro BNP is a sensitive and specific marker to identify cardiac or pulmonary dyspnea.