B型钠尿肽测定对心源性呼吸困难的诊断意义

目的:研究血浆中B型钠尿肽(BNP)浓度在急诊心源性和非心源性呼吸困难之间鉴别诊断中的价值.方法:对急诊科以呼吸困难为主诉而除外创伤、急性冠脉综合征、心包填塞的患者作床旁快速血浆BNP浓度测定.按照症状、体征、病史、辅助检查和对治疗后评估分成无心源因素组和有心源因素组,后者再细分成仅有心源因素组和心源因素加肺部疾患组....

Significance of B-Type Natriuretic Peptide in Diagnosis of Cardiac Dyspnea

Objective:To research diagnosis value of B-type natriuretic peptide in cardiac dyspnea and non-cardiac dyspnea.Methods:The patients with dyspnea who were sent to the emergency department,and excluded difficulty breathing caused by trauma、acute coronary syndrome、cardiac tamponade,had rapidly determination of plasma BNP levels at the bedside.According to symptoms、signs、medical history、laboratory examinations、evaluation after treatment,the patients were divided into heart factor group or no heart factor group,the latter had heart factor only and heart factor and pulmonary disease.Results:Concentration of plasma BNP were 91±64 pg/mL、1 485±1 131 pg/mL、591±531 pg/mL,there were significant differences in these groups(P<0.01).The average plasma BNP concentration of no cardiac dyspnea(namely in no heart factor group) was 285 pg/mL,Accuracy,sensitivity and specificity of the diagnosis were 93.6%、88.8%、98.7%.The average plasma BNP concentration of cardiac dyspnea which had heart factor only and heart factor group + pulmonary disease was 897 pg/mL,Accuracy,sensitivity and specificity of the diagnosis were 67.7%、64.6%、91.7%.Conclusion:the patients are sent to emergency department,whose plasma concentration of BNP≤285 pg/mL,the difficulty breathing are of non-cardiac;whose BNP 286-896 pg/mL,are of cardiac + pulmonary disease;whose plasma BNP≥897 pg/mL,are of cardiac disease.Bedside determination of BNP is the significance in the diagnosis and treatment of emergency breathing difficulties.