氨基末端-B型脑钠肽水平测定在肺源性与心源性呼吸困难中的鉴别意义

目的探讨氨基末端-B型脑钠肽（NT-proBNP）水平的测定在肺源性与心源性呼吸困难鉴别诊断的临床意义。方法选取我院ICU收治的肺源性呼吸困难33例,心源性呼吸困难48例,比较分析两组患者的临床资料及其NT-proBNP水平。选择同期心内科住院心功能正常的50例患者进行对照。结果 NT-proBNP水平在肺源性呼吸困难和心源性呼吸困难中分别为（610±293）pg/ml和（3263±384）pg/ml,其差异具有显著统计学意义（P〈0.01）,与对照组[（152±201）pg/ml]比较差异有显著统计学意义（P均〈0.01）,且在心源性呼吸困难组中NYHA心功能分级Ⅲ、Ⅳ级的NT-proBNP水平差异亦存在统计学意义（P〈0.05）,心功能越差,NT-proBNP越高。结论 NT-proBNP测定对肺源性及心源性呼吸困难的鉴别有重要意义,对心功能不全程度评定也有一定价值。

Value of NT-proBNP levels in the differential diagnosis of pulmonary and cardiac dyspnea

Objective To investigate the value of NT-proBNP levels in the differential diagnosis of pulmonary and cardiac dyspnea. Methods Thirty-three patients with pulmonary dyspnea （group A） and 48 patients with cardiac dyspnea （group B） in ICU were enrolled in the study. The clinical data and the plasma NT-proBNP levels were compared between the two groups. Fifty patients with normal cardiac function from Department of Cardiology were selected as the control group. Results The plasma NT-proBNP level was （610±293） pg/ml in group A and （3 263±384） pg/ml in group B, with statistically significant difference between the two groups （P0.01）. The plasma NT-proB-NP level in the control group was （152±201） pg/ml, showing marked significant difference with group A and group B （P0.01）. In group B, the plasma NT-proBNP level showed significant difference between NYHA Ⅲ and NYHA Ⅳ （P0.05）. The poorer the heart function, the higher the plasma NT-proBNP level. Conclusion The plasma NT-proB-NP level play an important role to differentiate pulmonary dyspnea from cardiac dyspnea, which has certain clinical significance in evaluating the degree of cardiac insufficiency.