氨基末端脑钠肽前体鉴别心源性和非心源性呼吸困难的临床价值  

Clinical Value of Amino-terminal Brain Natriuretic Peptide Precursors to Identify Cardiogenic and Non-cardiogenic Dyspnea

作　　者：宋春青 SONG Chunqing(Department of Emergency Medicine,Wuxi People's Hospital,Nanjing Medical University,Wuxi,Jiangsu Province,214023 China)

机构地区：[1]南京医科大学附属无锡市人民医院急诊科,江苏无锡214023

出　　处：《系统医学》2022年第21期86-89,共4页Systems Medicine

摘　　要：目的 分析心源性呼吸困难与非心源性呼吸困难患者采用氨基末端脑钠肽前体鉴别的应用价值,比较不同病因呼吸困难患者心功能差异。方法 选取2019年12月—2021年12月通过医院信息系统(hospital information system, HIS)解锁南京医科大学附属无锡市人民医院急诊科收治的呼吸困难患者346例,根据患者病因划分观察Ⅰ组(心源性呼吸困难,174例)与观察Ⅱ组(非心源性呼吸困难,172例),选择同期本院接诊健康体检者170名作为对照组,检测并对比3组氨基末端脑钠肽前体指标,另外针对不同病因呼吸困难患者进行超声心动图检查,比较两组患者心功能(左室舒张末期内径、左房舒张末期内径、左室射血分数)指标差异。结果 观察Ⅰ组患者氨基末端脑钠肽前体指标(955.48±22.19)pg/mL明显高于观察Ⅱ组及对照组,差异有统计学意义(P<0.05)。观察Ⅰ组与观察Ⅱ组患者左室舒张末期内径、左房舒张末期内径比较,差异无统计学意义(P>0.05),观察Ⅰ组患者左室射血分数(38.82±3.55)%明显低于观察Ⅱ组,差异有统计学意义(t=39.967,P<0.05)。结论 临床可通过检测呼吸困难患者氨基末端脑钠肽前体指标用于鉴别心源性与非心源性病因,操作简单。Objective To analyze the value of using amino-terminal brain natriuretic peptide precursors in the differential diagnosis of patients with cardiogenic dyspnea and non-cardiogenic dyspnea. To compare the differences in cardiac function in patients with different etiologies of dyspnea. Methods 346 patients with dyspnea who were admitted to the emergency department of Wuxi People’s Hospital, Nanjing Medical University through the hospital information system(HIS) from December 2019 to December 2021 were selected. The patients were divided into observation group Ⅰ(cardiogenic dyspnea, 174 cases) and observation group Ⅱ(non-cardiogenic dyspnea, 172 cases) according to their etiology. In the same period, 170 people who received health check-ups in the hospital were selected as the control group. Detected and compared the amino-terminal pro-brain natriuretic peptide indexes of three groups, and echocardiography was performed for patients with different etiologies of dyspnea. The differences of cardiac function(left ventricular end-diastolic internal diameter, left atrial end-diastolic internal diameter, and left ventricular ejection fraction) indexes were compared between the two groups. Results The amino-terminal pro-brain natriuretic peptide precursor index(955.48±22.19) pg/mL in observation group Ⅰ was significantly higher than that in observation group Ⅱand the control group, the difference was statistically significant(P<0.05). There was no statistically statistical difference between the results of left ventricular end-diastolic internal diameter and left atrial end-diastolic internal diameter of patients in observation group Ⅰ and observation group Ⅱ(P>0.05). The left ventricular ejection fraction(38.82±3.55)% in group Ⅰ was significantly lower than that in group Ⅱ, the difference was statistically significant(t=39.967, P<0.05). Conclusion Clinical use of amino-terminal pro-brain natriuretic precursor index for identifying cardiogenic and non-cardiogenic causes of dyspnea is simple.

关 键 词：氨基末端脑钠肽前体 心源性呼吸困难 非心源性呼吸困难 鉴别 

分 类 号：R44[医药卫生—诊断学]