脑型钠利尿肽在心力衰竭诊断与鉴别诊断中的意义  

Research of brain natriuretic peptide in dignose and discriminate heart failures

作　　者：柴伟利[1] 王同成[1] 

机构地区：[1]济南市第三人民医院,山东济南250101

出　　处：《山东医药》2008年第28期4-5,共2页Shandong Medical Journal

基　　金：济南市科技局科技发展计划项目(2007-34)

摘　　要：目的观察心力衰竭患者血浆B型钠利尿肽(BNP)水平的变化,旨在为临床诊断及鉴别诊断提供依据。方法将心血管病患者分成左室收缩功能衰竭组(A组)、左室舒张功能衰竭组(B组)和左室功能正常组(对照组)。评定三组的心功能,同时测定血浆BNP水平。结果①A组、B组、对照组BNP水平分别为(456.1±386.4)、(69.5±54.3)、(15.3±7.8)pg/ml,组间比较有统计学差异(P<0.01);②以BNP≥30 pg/ml作为诊断舒张性左室衰竭的分界值,其灵敏度为82%,特异度为100%;③以BNP≥230 pg/ml作为舒张性与收缩性左室衰竭鉴别诊断的分界值,其特异度为96%,灵敏度为95%。结论血浆BNP检测为诊断舒张性心力衰竭提供了新的方法,对鉴别舒张性左室衰竭和收缩性左室衰竭有重要参考价值。Objective To study the plasma level of B-type uatriuretic peptide in the patients with heart failure, so as to provide some information to clinical diagnosis and distinguish diagnosis. Methods 70 cases were divided into three groups, systolic heart failure group, diastolic heart failure group and normal group. The heart function were measured and plasma samples were obtained to detect BNP levels, then the results were compared. Statistic analysis was done with SPSS 11.5 software. Results （1）The average BNP level of the three group of SHF, DHF and normal group were （456.1 ± 386.4 ）, （69.5 ± 54.3 ）, （ 15.3 ±7.8）pg/ml. （2） If we take the BNP ≥30 pg/ml to dignose HF, the sensitivity is 82%, the distinction is 100%. （3） If we take the BNP≥230 pg/ml to distinguish systolic heart failure and diastolic heart failure, the sensitivity is 96% ,the distinction is 95%. Conclusions The plasma BNP level has optimal value to diagnos diastolic LV failure and distinguish the diastolic and systolic LV failure.

关 键 词：脑型钠利尿肽 心力衰竭 诊断 鉴别 

分 类 号：R541[医药卫生—心血管疾病]