重庆市永川区急性呼吸困难患者NT-proBNP及灰区间疾病研究的临床意义

Clinical Significance of NT-proBNP and Gray Interval Disease in Patients with Acute Dyspnea in Yongchuan,Chongqing

目的：探讨血浆NT—proBNP水平在急性心源性呼吸困难（心力衰竭）与非心源性呼吸困难患者中诊断及“灰区值”的临床意义。方法：选择2013年3月～2015年2月我院呼吸科就诊的急性呼吸困难患者300例，分成心源性呼吸困难组（152例）和非心源性呼吸困难组（148例），并设健康对照组100例，检测血浆NT—proBNP水平，分析急性呼吸困难患者NT—proBNP“灰区值”疾病及其所占比例。结果：心源性呼吸困难与非心源性呼吸困难组血浆NT—proBNP水平比较明显升高，分别为（2562．57±847．53）ng／L和（341．84±80．57）ng／L，有显著性差异（P〈0．01）。心源性呼吸困难组“灰区值”患者33例，占21．7％；非心源性呼吸困难组30例，占20．3％；300例入选患者中“灰区值”者占63例，占21．0％；对照组0例。2组“灰区值”比较无统计学意义（P〉0．05），与健康对照组比较有显著统计学意义（P〈0．01）。结论：呼吸困难患者血浆NT—proBNP水平对鉴别及诊断心源性和非心源性呼吸困难准确性高，针对“灰区值”患者的进一步检查可以对入院及出院患者的危险分层和管理提供帮助，值得推广应用。

Objective： To investigate the clinical significance of plasma NT-proBNP levels in the diagnosis of acute cardiac dyspnea （heart failure） and the ＂ gray area＂ in patients with non-cardiac dyspnea. Method：From March 2013 to February 2015, 300 patients with acute dyspnea in our hospital were chosen and divided into a cardiogenic dyspnea group （152 cases）, a non-cardiac dyspnea group （148 cases）, and a healthy control group （100 cases） , to detect the level of NT-proBNP, and to analyze the ＂gray area＂ disease and the proportion of NT-proBNP in patients with acute dyspnea. Results： The levels of NT-proBNP in the patients with cardiac dyspnea and non-cardiac dyspnea were significantly higher, 2562. 57 ± 847.53ng/L and 341.84 8 ± 0. 57ng/L, respectively, with a significant difference （P 〈0. 01 ）. The ＂gray area＂ in patients with cardiac dyspnea group was 33, accounting for 21.7% ; 30 in the non-cardiac dyspnea group, accounting for 20. 3% ; 63 out of the 300 patients, accounting for 21% ; and 0 in control group. There was no statistical significance （ P 〉0. 05 ） between the 2 groups, compared with the healthy control group （P 〈0.01 ）. Conclusion： The level of serum NT-proBNP in patients with dyspnea has a high accuracy in the diagnosis and diagnosis of cardiac and non-cardiac dyspnea. Further examination of the ＂gray area＂ patients can provide help for the risk stratification and management of hospital admission and discharge.