肺超声联合血清N端脑钠肽前体在心源性及肺源性呼吸困难中的诊断价值

Diagnostic value of lung ultrasound combined with serum N-terminal pro-brain natriuretic peptide in cardiogenic and pulmonary dyspnea

目的探讨肺超声联合血清N端脑钠肽前体(NT-proBNP)在心源性及肺源性呼吸困难中的诊断价值。方法选取2018年10月到2021年9月石家庄市第三医院收治的55例心源性呼吸困难患者以及50例肺源性呼吸困难患者作为研究对象,分别作为心源性组和肺源性组,均进行肺超声诊断以及血清NT-proBNP水平测定诊断。比较心源性组与肺源性组的血清NT-proBNP水平及阳性率、肺超声检查阳性率。以综合病理诊断为金标准诊断结果,研究肺超声联合血清NT-proBNP检测的诊断效能,包括灵敏度、特异度和准确率。结果心源性组患者的血清NT-proBNP水平、血清NT-proBNP阳性率均高于肺源性组,肺超声阳性率低于肺源性组,差异有统计学意义(P<0.05)。单独血清NT-proBNP检测对心源性呼吸困难的诊断灵敏度为100.00%(55/55),特异度为90.00%(45/50),准确率为95.24%(100/105)。肺超声联合血清NT-proBNP检测对心源性呼吸困难的诊断灵敏度为100.00%(55/55),特异度为96.00%(48/50),准确率为98.10%(103/105)。肺超声联合血清NT-proBNP检测与单独血清NT-proBNP检测对心源性呼吸困难的诊断灵敏度、特异度、准确率比较,差异均无统计学意义(P>0.05)。单独肺超声对肺源性呼吸困难的诊断灵敏度为98.00%(49/50),特异度为96.36%(53/55),准确率为97.14%(102/105)。肺超声联合血清NT-proBNP检测对心源性呼吸困难的诊断灵敏度为98.00%(49/50),特异度为100.00%(55/55),准确率为99.05%(104/105)。肺超声联合血清NT-proBNP检测与单独肺超声检测对心源性呼吸困难的诊断灵敏度、特异度、准确率比较,差异均无统计学意义(P>0.05)。结论肺超声联合血清NT-proBNP在心源性及肺源性呼吸困难的诊断中,均具有较高的诊断效能,能够为心源性及肺源性呼吸困难的临床诊断提供重要的依据。

Objective To investigate the diagnostic value of lung ultrasound combined with serum N-terminal pro-brain natriuretic peptide(NT-proBNP)in cardiogenic and pulmonary dyspnea.Methods From October 2018 to September 2021,55 patients with cardiogenic dyspnea and 50 patients with pulmonary dyspnea treated in the Third Hospital of Shijiazhuang City were selected as study subjects,they were divided into cardiogenic group and pulmonary group.Pulmonary ultrasound diagnosis and serum NT-proBNP level determination were performed in all patients.The serum NT-proBNP level and positive rate of lung ultrasound were compared between the cardiogenic group and the pulmonary group.Taking comprehensive pathological diagnosis as the gold standard diagnostic result,the diagnostic efficacy of lung ultrasound combined with serum NT-proBNP detection was studied,including sensitivity,specificity and accuracy.Results The serum level of NT-proBNP and the positive rate of serum NT-proBNP in the cardiogenic group were higher than those in the pulmonary group,and the positive rate of pulmonary ultrasound was lower than that in the pulmonary group,the differences were statistically significant(P<0.05).The sensitivity and specificity of serum NT-proBNP for the diagnosis of cardiac dyspnea were 100.00%(55/55),90.00%(45/50)and 95.24%(100/105)respectively.The sensitivity,specificity and accuracy of lung ultrasound combined with serum NT-proBNP detection in the diagnosis of cardiogenic dyspnea were 100.00%(55/55),96.00%(48/50)and 98.10%(103/105).There were no statistical significances in the diagnostic sensitivity,specificity and accuracy of pulmonary ultrasound combined with serum NT-proBNP detection and single serum NT-proBNP detection for cardiogenic dyspnea(P>0.05).The sensitivity,specificity and accuracy of single lung ultrasound for diagnosing pulmonary dyspnea were 98.00%(49/50),96.36%(53/55)and 97.14%(102/105).The sensitivity,specificity and accuracy of lung ultrasound combined with serum NT-proBNP detection for the diagnosis of cardiogenic dyspnea were 98.00%(49/50),100.00%(55/55)and 99.05%(104/105).There were no statistical significances in the diagnostic sensitivity,specificity and accuracy of lung ultrasound combined with serum NT-proBNP detection of single lung ultrasound detection for cardiac dyspnea(P>0.05).Conclusion Lung ultrasound combined with serum NT-proBNP has a high diagnostic efficiency in the diagnosis of cardiogenic and pulmonary dyspnea,which can provide an important basis for the clinical diagnosis of cardiogenic and pulmonary dyspnea.