血浆脑钠肽前体N-末端片段对心衰和呼吸困难的诊断价值

目的探讨心力衰竭患者及肺源性呼吸困难患者血浆脑钠肽前体水平检测的临床意义。方法采用罗氏Elecsys2010全自动电化学发光免疫分析仪测测定112例心衰患者、肺源性呼吸困难患者37例及20例正常人血浆NT-proBNP,心衰患者同时测定左室舒张末横径（LVEDD）、左室射血分数（LVEF）。结果心源性呼吸困难组NT-proBNP水平显著高于肺源性呼吸困难组及对照组（P〈0.01）。血浆NT-proBNP水平在心功能Ⅱ级、Ⅲ级、Ⅳ级两两比较（P〈0.01）,LVEF、LVEDD在3组间两两比较（P〈0.05）,均有统计学差异。NT-proBNP水平与LVEDD呈正相关（r=0.78,P〈0.01）,而与LVEF呈负相关（r=-0.69,P〈0.01）。结论血浆NT-proBNP定量测定对呼吸困难的鉴别诊断以及心衰的诊断、预后评估具有很高的临床价值。

The diagnostic value of the NT-proBNP in congestive heart failure and breathing difficulties

Objective To investigate the clinical significance of the detection of patients with heart failure and pul monary derived breathing difficulties in patients with plasma brain natriuretic peptide precursor level. Methods the Roche Elecsys2010 automatic eleetrochemilumineseence immunoassay analyzer measurements for the determination of the 112 cases of patients with heart failure, pulmonary dyspnea in 37 cases and 20 cases of normal human plasma of NT- proBNP in heart failure patients with simultaneous determination of left ventricular end diastolic cross diameter （LVEDD） ,left ventricular ejection fraction （LVEF）. Results The cardiac dyspnea group, NT-proBNP levels were sig nificantly higher than that of pulmonary dyspnea group and control group （P;0. 01）. Plasma NT-proBNP level of heart function grade Ⅱ,Ⅲ grade level IV pairwise comparisons （P;0.01）, LVEF, LVEDD were among the three groups,pairwise comparisons （P;0.05） were statistically significant. NT-proBNP levels with LVEDD was positively correlated （r=0.78,P〈0.01） ,and LVEF was negatively correlated （r-=-0.69,P〈0.01）. Conclusion The quantita rive determination of plasma NT-proBNP breathing difficulties in the differential diagnosis of heart failure diagnosis, prognostic evaluation has high clinical value.