B型钠尿肽和CA125联合检测在呼吸困难鉴别诊断中的临床价值

Clinical value of B-type natriuretic peptide combined with CA125 detectioninthe differential diagnosis of dyspnea

目的探讨B型钠尿肽(BNP)和糖类抗原125(CA125)联合检测在呼吸困难鉴别诊断中的临床价值。方法收集本院2010年12月至2013年12月收治的100例心源性呼吸困难患者、64例肺源性呼吸困难患者与86例健康者的一般资料,检测并比较所有研究对象血浆BNP、CA125水平,分析BNP、CA125联合检测的灵敏度、特异性。结果心源性组患者血浆BNP、CA125水平均高于肺源性组,且两组均高于对照组(P<0.05)。心功能分级Ⅳ级患者血浆BNP、CA125水平高于心功能分级Ⅲ级患者,心功能分级Ⅲ级患者血浆BNP、CA125水平高于Ⅱ级(P<0.05)。联合检测BNP和CA125诊断灵敏度为92.68%,特异度为95.35%,均高于二者单独检测(P<0.001)。结论 BNP和CA125联合检测有较高的灵敏度与特异度,可以鉴别诊断心源性与肺源性呼吸困难,值得临床推广应用。

Objective To explore the clinical value of B-type natriuretic peptide（BNP） combined with carbohydrate antigen（CA125） detection in the differential diagnosis of dyspnea. Method General data of 100 patients with cardiogenic dyspnea, 64 patients withpulmonary dyspnea and 86 cases of healthy people admitted in our hospital from December 2010 to December 2013 were collected. The levels of BNP, CA125 were tested. The sensitivity and specificity of BNP combining CA125 were analyzed. Result The levels of BNP, CA125 in cardiogenic dyspnea group were higher than pulmonary dyspnea group（P〈0.05）; the levels of BNP, CA125 of cardiac function grade Ⅳ were higher than grade Ⅲ（P〈0.05）; the levels of BNP, CA125 of cardiac function grade Ⅲ were higher than grade Ⅱ（P〈0.05）; the diagnostic sensitivity of BNP combined CA215 was 92.68%, and the specificity was 95.35%, which was significantly higher than BNP or CA215 test alone（P〈0.05）. Conclusion B-type natriuretic peptide and CA125 combined detection has a high sensitivity and specificity, which can differentially diagnose cardiogenic and pulmonary dyspnea, with the worth of clinical application.