血清BNP检测在急性呼吸困难鉴别诊断中的作用  

The role of BNP in the differential diagnosis of the acute dyspnea

作　　者：陈占龙[1,2] 杨腊梅[1,3] 陈梦飞[1,2] 杨晓明[1,2] 张玲[1,2] 

机构地区：[1]宁夏人民医院急诊科,宁夏银川750002 [2]西北民族大学第一临床医学院急诊科,宁夏银川750002 [3]西北民族大学第一临床医学院ICU,宁夏银川750002

出　　处：《宁夏医学杂志》2017年第2期118-120,共3页Ningxia Medical Journal

摘　　要：目的探讨血脑利钠肽(BNP)在急性呼吸困难患者鉴别诊断中的价值。方法选取以急性呼吸困难为主诉就诊的患者110例,其中心源性呼吸困难组58例,非心源性呼吸困难组52例,检测2组患者BNP水平。结果心源性呼吸困难组患者BNP为(502.18±120.52)pg/m L,明显高于非心源性呼吸困难组,差异有统计学意义(P<0.05);不同心功能分级患者BNP比较差异有统计学意义(P<0.05),其中心功能Ⅳ级患者BNP为(1 021.81±235.20)pg/m L,明显高于心功能Ⅱ级和Ⅲ级患者,差异有统计学意义(P<0.05);BNP诊断心源性呼吸困难的ROC曲线下面积为0.977(P<0.05),诊断阈值为300 pg/m L,灵敏度为96.60%,特异度为90.38%。结论 BNP有助于心源性呼吸困难的鉴别诊断,值得在临床推广使用。Objective To investigate the value of blood brain natriuretic peptide （BNP） in the differential diagnosis of the acute dyspnea. Methods 110 patients with acute dyspnea were treated in our hospital. ,among them,558 cases of cardiac dyspnea group, and 52 cases of non cardiac dyspnea group, detected two groups BNP. Results TheBNP in the Cardiac dyspnea patients BNP was （ 502.18 ± 20.52） pg/mL,which significantly higher than non - cardiac dyspnea group. The difference was statistically significant （P 〈 0.05）. The BNP in the patients of;Different cardiac function patients BNP was statistically significant （P 〈 0. 05 ）. The BNPin cardiac function Ⅳ grade patients with Cardiac functioniV grade BNP was （ 1021,81± 235.20） pg/mL,which significantly higher than in patients with grade Ⅱ and m, the difference was statistically significance （P 〈 0.05 ）. The area under the ROC curve of BNP diagnosis of cardiac dyspnea was 0. 977 （P 〈 0.05 ）. The diagnostic threshold was 300 pg/mL, the sensitivity was 96.60%, and the specificity was 90.38%. Conclusion BNP is helpful in the differential diagnosis of cardiac dyspnea,it is worth to be popularized in clinical application.

关 键 词：脑利钠肽 急性呼吸困难 心源性 诊断价值 

分 类 号：R563.8[医药卫生—呼吸系统]