论文部分内容阅读
目的:研究快速检测血浆脑钠肽(Brain natriuretic peptide,BNP)水平对初步鉴别心源性呼吸困难与肺源性呼吸困难的临床价值。方法:选择有呼吸困难表现的慢性心衰患者249例作为心源性呼吸困难组,按NYHA分级,将其分为NYⅡ、NYⅢ和NYⅣ级3个亚组。选择因单纯肺部疾病引起呼吸困难患者128例作为肺源性呼吸困难组即对照组,并分别测定各组BNP水平和左心室射血分数(LVEF)。比较两组间及不同心功能级别之间的BNP水平及LVEF。结果:BNP水平心源性呼吸困难组显著高于肺源性呼吸困难组,LVEF水平心源性呼吸困难组显著低于肺源性呼吸困难组,差异均有统计学意义(P<0.05),BNP水平随着心功能级别升高而升高,LVEF与BNP水平呈负相关,差异有统计学意义(P<0.05)。结论:BNP可作为初步鉴别心源性呼吸困难与肺源性呼吸困难的一个敏感指标,快速检测血浆BNP水平有较好的临床价值,尤其适用于急诊内科医生。
Objective: To investigate the clinical value of rapid detection of plasma brain natriuretic peptide (BNP) levels in the differential diagnosis of cardiorespiratory dysfunction and pulmonary dyspnea. Methods: A total of 249 patients with chronic heart failure who had dyspnea were selected as the cardiogenic dyspnea group. They were divided into three groups: NY Ⅱ, NY Ⅲ and NYⅣ according to NYHA classification. 128 patients with dyspnoea caused by simple pulmonary diseases were selected as the control group of pulmonary dyspnea group. BNP level and left ventricular ejection fraction (LVEF) were determined in each group. BNP levels and LVEF between two groups and between different cardiac function levels were compared. Results: BNP level in cardiorespiratory dysfunction group was significantly higher than that in pulmonary dyspnea group, LVEF level cardiogenic dyspnea group was significantly lower than that in pulmonary dyspnea group, the differences were statistically significant (P <0.05) BNP levels increased with the increase of cardiac function level, and LVEF was negatively correlated with BNP level, the difference was statistically significant (P <0.05). Conclusion: BNP can be used as a sensitive index to differentiate cardiogenic dyspnea and pulmonary dyspnea. It has good clinical value for rapid detection of plasma BNP level, especially for emergency physicians.