血BNP，hs—CRP和cTnI水平在呼吸困难患者中的临床鉴别诊断价值  

Clinical Differential Diagnosis Value of Detecting Blood BNP, hs-CR and cTnI Levels in Patients with Dyspnea

作　　者：谈昀[1] 曾宪飞[1] 李军民[1] 王小刚[1] 

机构地区：[1]武警陕西总队医院检验科,西安710054

出　　处：《现代检验医学杂志》2012年第4期38-40,43,共4页Journal of Modern Laboratory Medicine

摘　　要：目的探讨BNP，hs—CRP和cTnI联合检测在呼吸困难患者中的应用价值。方法对2010年02月～2011年06月期间ICU病房呼吸困难患者140例（分为两组：心源性84例，肺源性56例），两组患者均符合ICU入住标准，均采用美国纽约心脏病学会（NYHA）心功能分级标准进行分级，其中Ⅱ级49例、Ⅲ级60例、Ⅳ级31例。排除气胸、肺源性心肌病、宫壁瘤等。采用免疫荧光法、微粒增强免疫透射比浊法分别对血BNP，cTnI和hs—CRP水平进行检测，通过血气分析、心脏B超、X线胸片、心电监护和心功能分级等资料进行治疗前后对比观察，并与健康对照组50例比较分析。结果血BNP，hs-CRP和cTnI水平在心源性呼吸困难与肺源性呼吸困难中均高于对照组（P〈0．01）。心源性呼吸困难组三项水平明显高于肺源性呼吸困难组且心功能越差，其浓度越高（P〈0．01），且三项联合检测的阳性率明显高于单项检测。结论测定血BNP，hs-CRP和cTnI水平用于早期鉴别心源性呼吸困难和肺源性呼吸困难，可以作为诊断或排除呼吸困难中充血性心力衰竭（CHF）发病机理和恶化程度，在急性呼吸困难患者中有重要临床意义。Objective To study on application value of BNP,hs-CRP and cTnI combined detection in patients with dyspnea in application value. Methods On Feb. 2010-Jun. 2011 during inpatient ICU ward patients with dyspnea in 140 patients （divided into two groups of cardiogenic in 84 cases,pulmonary： report of 56 cases）, two groups of patients were consistent with ICU occupancy standards,using the United States New York Heart Association （NYHA） cardiac functional grading stand- ards for classification, in which 49 cases in grade II , 60 cases in grade HI, IV in 31 cases. Excluded pneumothorax, pulmonary cardiomyopathy, palace wall tumour. Using immunofluorescence assay, particle enhanced immunoturbidimetric assay on blood BNP, cTnI and hs-CRP levels were detected. The blood gas analysis,cardiac B-mode ultrasonography, X-ray, ECG and heart function classification and other data were observed before and after treatment, and compared with a healthy control group of 50 cases. Results Blood BNP, hs-CRP and cTnI levels in cardiogenic dyspnea and pulmonary dyspnea were higher than those of control group （P〈0. 01）. Cardiogenic dyspnea group three levels were significantly higher pulmonary dyspnea group and cardiac function was poor. Its concentration was higher （P〈0. 01）, and the three joint detection positive rate was significantly higher than that of single detection. Conclusion Determination of blood BNP, hs-CRP and cTnI levels for the early identification of cardiac and pulmonary dyspnea,can beused as a diagnosis or exclusion of dyspnea in congestive heart failure （CHF） pathogenesis and degree of deterioration. There is a important clinical significance in patients with acute dysp- noea.

关 键 词：B型钠尿肽 高敏C反应蛋白 肌钙蛋白I 呼吸困难 

分 类 号：R392.11[医药卫生—免疫学]