血浆脑利钠肽在快速鉴别诊断心源性和肺源性呼吸困难中的价值  

Value of plasma brain natriuretic peptide for differentiating cardiogenic dyspnea from pulmogenic dyspnea

作　　者：瞿跃进[1] 俞浩[2] 陈贵兵[2] 方亚[3] 黄劲雄[2] 何小江[2] 

机构地区：[1]厦门市第一医院呼吸内科,361003 [2]厦门市第一医院核医学科 [3]厦门大学医学院预防医学系,361003

出　　处：《国际放射医学核医学杂志》2008年第4期218-220,共3页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的评价血浆脑利钠肽（BNP）水平在心源性和肺源性呼吸困难时鉴别诊断的价值。方法采用美国拜尔公司生产的化学发光检测仪及其BNP试剂，检测248例因呼吸困难住院的肺疾病患者血浆BNP水平，对单纯肺疾病患者、肺疾病并发左心功能不全患者、肺疾病未并发左心功能不全患者、肺疾病并发右心衰患者各组间BNP水平进行比较。结果肺疾病并发左心功能不全的呼吸困难患者的BNP水平明显高于未并发左心功能不全的呼吸困难患者（x^2=25．597，P〈0．001）；肺疾病并发右心衰患者BNP水平高于单纯肺疾病患者，但差异没有统计学意义（t=1．614，P〉0．05）；肺疾病并发左心功能不全患者的BNP水平明显高于肺疾病并发右心衰患者（t=2．531，P〈0．05）；肺疾病并发左心功能不全患者的心功能越差，BNP水平就越高，心功能Ⅱ、Ⅲ、Ⅳ级三组间BNP水平的差别有统计学意义（x^2=29．463，P〈0．001）。结论血浆BNP是快速鉴别诊断心源性和肺源性呼吸困难的重要实验室检测指标，同时可判断肺疾病并发左心功能不全患者心衰的严重程度。Objective To evaluate the value of plasma brain natriuretic peptide （BNP）level for differentiating cardiogenic dyspnea from pulmogenic dyspnea. Methods The detection of plasma BNP was carried out in 248 patients with dyspnea. The apparatus was the CENTUR type chemiluminescence detection produced by the Bayer companies of USA. All patients were divided into three groups depending on disease severity. The level of plasma BNP in each group was compared. Results The level of plasma BNP in pulmonary disease complicated with left ventrieular dysfunction was higher than that of pulmonary disease non-complicated with left ventricular dysfunction. There was significant difference between two groups（x^2= 25.597, P〈0.001 ）. The level of plasma BNP in pulmonary disease complicated with right ventricular dysfunction was higher than that of simple pulmonary disease. There was no significant difference between two groups （t=1.614, P〉0.05 ） . The level of plasma BNP in pulmonary disease complicated with left ventricular dysfunction was higher than that of pulmonary disease complicated with right ventricular dysfunction. There was significant difference between two groups （t=2.531, P〈0.05） . If the left ventricular dysfunction degree was notable, the level of plasma BNP was high. There was also significant difference in different cardiac function classification by New York Heart Association （X^2=29.463, P〈0.001）. Conclusion Plasma BNP analysis is an importent method for differentiating cardiogenic dyspnea from pulmogenie dyspnea. Meanwhile, it is also helpful to evaluating the severity of pulmonary disease complicated with left ventricular dysfunction.

关 键 词：呼吸困难 利钠肽 脑 心室功能障碍 左 

分 类 号：R541.6[医药卫生—心血管疾病]