血清N末端B型利钠肽原水平在老年急性呼吸困难鉴别诊断和病情评估中的临床应用价值分析

Clinical value analysis of serum N-terminal B-type natriuretic peptide level applied to differential diagnosis and assessment on elderly patients with acute dyspnea

目的分析血清N末端B型利钠肽原(NT-proBNP)水平在老年急性呼吸困难鉴别诊断和病情评估中的临床应用价值。方法随机选取2016年5月至2018年5月我院急诊科收治的老年急性呼吸困难患者100例为研究对象,包括心源性呼吸困难(组)和肺源性呼吸困难(组)患者各50例。检测比较两组患者的血清NT-proBNP水平、左室舒张末期内径(LVEDD)、左心室射血分数(LVEF)。对心源性呼吸困难患者进行心功能分级,比较不同心功能分级患者的血清NT-proBNP水平、LVEDD、LVEF;分析患者血清NT-proBNP水平与LVEF的关系。结果心源性呼吸困难组患者的血清NT-proBNP水平和LVEDD明显高(大)于肺源性呼吸困难组,LVEF明显低于肺源性呼吸困难组,差异有统计学意义(P<0.05)。心源性呼吸困难患者的血清NT-proBNP水平与LVEDD表现为Ⅳ级>Ⅲ级>Ⅱ级,LVEF表现为Ⅳ级<Ⅲ级<Ⅱ级,差异有统计学意义(P<0.05)。Pearson分析结果显示,心源性呼吸困难组患者的血清NT-proBNP水平与LVEF呈负相关(r=-0.685,P<0.017)。结论血清N末端B型利钠肽原水平在老年急性呼吸困难的鉴别诊断和病情评估中具有较高的临床应用价值,有助于心源性和肺源性呼吸困难的鉴别诊断,对及时采取正确治疗措施、挽救患者生命具有重要意义。

Objective To analyze the clinical value of serum N-terminal B-type natriuretic peptide(NT-proBNP) level applied to differential diagnosis and assessment on elderly patients with acute dyspnea.Methods A total of 100 elderly patients with acute dyspnea admitted to our hospital from May 2016 to May 2018 were randomly selected as the research objects,including 50 cases with cardiogenic dyspnea (group) and 50 cases with pulmonary dyspnea (group).Serum NT-proBNP levels,left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) were compared between the two groups.Patients were graded by cardiac function and compared with different grades in serum NT-proBNP level,LVEDD and LVEF,and the relationship between serum NT-proBNP level and LVEF was analyzed.Results The cardiogenic dyspnea group had significantly higher (bigger) serum NT-proBNP level and LVEDD as well as lower LVEF in comparison with the pulmonary dyspnea group ( P <0.05).Serum NT-proBNP level and LVEDD on patients with cardiogenic dyspnea in ascending order were grade Ⅱ,grade Ⅲ and grade Ⅳ,and LVEF were grade Ⅳ,grade Ⅲ and grade II,the difference was statistically significant ( P <0.05).The results of Pearson analysis showed that serum NT-proBNP level were negatively correlated with LVEF on patients with cardiogenic dyspnea ( r=-0.685,P <0.017).Conclusion Serum NT-proBNP level has a high clinical application value to differential diagnosis and assessment on elderly patients with acute dyspnea;it is helpful for the differential diagnosis of cardiogenic and pulmonary dyspnea;and it has great significance on taking corrective measures and saving patients′ lives in time.