血脑利钠肽在急性呼吸困难鉴别诊断中的价值  

Diagnoses Value of Plasma Brain Natriuretic in Patients with Acute Dyspnea

作　　者：江勇[1] 施烯[1] 陈萍 蔺佩鸿[1] 郭平清[1] 林志鸿[1] 冯少丹[1] 

机构地区：[1]福建医科大学附属第一医院急诊科,福州350005 [2]福州第一医院心内科,福州350009

出　　处：《中国医药导刊》2006年第3期164-165,共2页Chinese Journal of Medicinal Guide

基　　金：福建省卫生厅青年科研基金资助项目(2003A044)

摘　　要：目的:探讨床边即时检测血脑利钠肽(BNP)在急性呼吸困难鉴别诊断价值。方法:荧光免疫法测定100例呼吸困难患者血浆BNP,心脏超声测定心脏左室射血分数(EF)。结果:(1)心力衰竭(HF)引起呼吸困难患者血浆BNP水平明显高于非心力衰竭组患者[(635．9±360．1)pg／ml与(54．5±35．7)pg／ml,P<0．01];(2)如以100pg／ml为正常参考值,BNP诊断心力衰竭敏感性为91．8％,特异性为92％;排除心力衰竭的阴性预测价值为92．1％;(3)如以大于500pg／ml为参考值BNP诊断HF特异性为100％。结论:床边即时检测BNP诊断心力衰竭敏感且特异,快速,可作为急性呼吸困难鉴别诊断的一个观察指标。Objective： To investigate differential diagnoses value of ultra - rapid bedside measurement of brain natriuretic peptide （BNP） in patients with Acute dyspnea. Methods： Plasma BNP concentration was measured with immunofluorescence assay in 100 patients with Acute dyspnea. Left ventricular ejection fraction （LVEF） were determined by echocardiography in these patients on the same time, respectively. Results： （1） Plasma BNP levels in the patients with heart failure were higher than those in the non - heart failure patients [ （ 635.9 ± 360.1 ） pg/ml vs （ 54.5 ± 35.7 ） pg/ml P 〈 0.01 ]. （2） The sensitivity, specificity and negative predictive values of plasma BNP levels ≥ 100pg/ml for predicting heart failure were 91.8%, 92% and 92.1%, respectively. （3） The specificity predictive values of plasma BNP levels≥ 500pg/ml for predicting heart failure were 100% ,respectively. Conclusion： Bedside BNP assay may be sensitive and specific for diagnosing heart failure, and is useful in acute dyspnea in emergemey care.

关 键 词：心力衰竭 呼吸困难 脑利钠肽 

分 类 号：R446.6[医药卫生—诊断学]