血清N末端B型钠尿肽前体对妇产科心源性与非心源性呼吸困难的鉴别诊断价值  

Diagnosis Value of Serum N Terminal B Type Natriuretic Peptide Precursor on Cardiac and Non-cardiac Respiratory Difficulty in Obstetrics and Gynecology Department

作　　者：王秀艳 周彩红 杨文东[2] 

机构地区：[1]山东省东营市东营区人民医院妇产科,257300 [2]山东省利津县第二人民医院

出　　处：《实用心脑肺血管病杂志》2014年第5期89-90,共2页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的 探讨血清N末端B型钠尿肽前体（NT-proBNP）在妇产科心源性和非心源性呼吸困难中的临床鉴别诊断价值.方法 选取2010年1月-2013年11月我院妇产科病房输液或输血过程中或输注后发生急性呼吸困难患者69例,根据其对强心利尿治疗的反应,将治疗后呼吸困难缓解者作为心源性呼吸困难组（41例）,将治疗后呼吸困难持续甚至加重者作为非心源性呼吸困难组（28例）.检测两组患者血清NT-proBNP水平.结果 心源性呼吸困难组NT-proBNP水平和阳性率均高于非心源性呼吸困难组（P＜0.05）.血清NT-proBNP诊断心源性呼吸困难敏感度为100.0％ （41/41）,特异度为92.9％ （26/28）,阳性预测值为95.4％ （41/43）,阴性预测值为100.0％ （26/26）.结论 妇产科心源性呼吸困难患者血清NT-proBNP水平显著高于非心源性呼吸困难者,血清NT-proBNP可作为鉴别心源性与非心源性呼吸困难的一项观察指标,具有高敏感度和特异度.Objective To explore the diagnosis value of serum N terminal B type natriuretic peptide precursor （NT-proBNP） on cardiac and non -cardiac respiratory difficulty in obstetrics and gynecology department. Methods 69 patients with acute respiratory distress admitted to our hospital from January 2010 to November 2013 were divided into cardiac dyspnea group （dyspnea remission, 41 cases） and non -cardiac dyspnea group （dyspnea continue even aggravated, 28 cases） according to patients＇s respons to cardiac diuretic treatment. The level of serum NT- proBNP between two groups was detected. Results The level of NT - proBNP and positive rate in cardiac dyspnea group were higher than those of non - cardiac dyspnea group （P 〈0. 05）. The sensitivity of serum NT- proBNP diagnostic cardiac dyspnea was 100. 0% （41/41）, specificity was 92. 9% （26/28）, positive predictive value was 95.4% （41/43）, negative predictive value was 100. 0% （26/26）. Conclusion The level of serum NT - proBNP in cardiac dyspnea is significantly higher than that of non - cardiac dyspnea in obstetrics and gynecology department. Serum NT - proBNP can be used as identification of cardiac and non - cardiac dyspnea, has high sensitivity and specificity.

关 键 词：妇产科 医院 呼吸困难 诊断 鉴别 N末端B型钠尿肽前体 

分 类 号：R441.8[医药卫生—诊断学] R446.1[医药卫生—临床医学]