脑利钠肽在呼吸困难鉴别诊断中的应用研究  

Value of brain natriuretic peptide level in differential diagnosis of dyspnea

作　　者：白红颖[1] 

机构地区：[1]首都医科大学附属北京同仁医院急诊科,北京100730

出　　处：《中国急救复苏与灾害医学杂志》2009年第12期949-950,957,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨血浆脑利钠肽（BNP）水平在急诊呼吸困难患者鉴别诊断中的应用价值。方法选择心源性呼吸困难的患者和非心源性呼吸困难的患者各50例以及无呼吸困难的对照组40例，采用免疫荧光法分别测定3组患者的血浆BNP水平。结果心源性呼吸困难组BNP水平为（624.3±137．9）pg／ml），显著高于非心源性呼吸困难组[（68．5±15．8）pg／ml]及对照组[（57．4±17．7）pg／ml]（均P〈0．05），而后两组之间BNP水平无显著差异（P〉0．05）。心源性呼吸困难组患者血浆BNP浓度与左室射血分数（LEVF）水平呈显著负相关（r=-0．775，P〈0．001），不同纽约心脏病协会心功能分级患者的血浆BNP浓度随心功能级别增加而显著增高。结论测定血浆BNP水平有助于急诊呼吸困难患者的诊断及鉴别诊断。Objective To investigate the value of plasma brain natriuretic peptide （BNP） level in differential diagnosis of dyspnea in department of emergency. Methods Blood samples were collected from 50 patients of cardiac dyspnea and 50 patients of non-cardiac dyspnea immediately after admission to the hospital or early next morning. And 40 healthy persons were used as control group .The plasma BNP levels were measured by immunofluorescence assay. Results The plasma BNP level of the cardiac dyspnea group was （624.3 ± 137.9）pg/ml, significantly higher than those of the non-cardiogenic dyspnea group [（68.5± 15.8） pg/ ml] and the control group [（57.4± 17.7） pg/ ml] （both P〈0.05）, however, there was no significant difference in the BNP level between these 2 latter groups （P〉0.05）. The plasma BNP level of the cardiac dyspnea group was significantly negatively correlated with the left ventricular ejection fraction （LEVF） level （r =-0.775, P 〈0.001）. The higher the grade in the New York Heart Association classification of heart function the higher the BNP levels. Conclusion Plasma BNP level is helpful in diagnose and differential diagnosis in patients with dyspnea in emergency treatment.

关 键 词：脑利钠肽 急性呼吸困难 心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]