B型钠尿肽对心源性与非心源性呼吸困难的鉴别诊断价值

目的探讨B型钠尿肽(B-Type natriuretic peptide,BNP)在鉴别心源性或非心源性疾病引起的呼吸困难中的诊断价值。方法选择心内科心源性疾病伴呼吸困难患者25例(NYHA心功能Ⅲ级18例,NYHA心功能Ⅳ级7例),非心源性疾病伴呼吸困难患者22例,同期健康体检者25例作为对照组。测量3组心脏左心室射血分数(LVEF)和血浆BNP,比较BNP与NYHA心功能分级及LVEF的关系。结果对照组、非心源性疾病呼吸困难组、心源性疾病呼吸困难组心脏LVEF分别为(60.82±5.53)%、(55.92±5.62)%和(40.25±4.85)%,差异有统计学意义(P<0.01)。心源性疾病呼吸困难组与对照组和非心源性疾病呼吸困难组之间血浆BNP浓度差异有统计学意义(P<0.01),对照组与非心源性疾病呼吸困难组间血浆BNP浓度差异无统计学意义(P>0.05)。BNP与LVEF呈负相关关系。结论血浆BNP浓度与NYHA心功能分级和LVEF具有很好的相关性,可能成为鉴别心源性和非心源性疾病引起呼吸困难的指标。

Differential Diagnosis Value of B-Type Natriuretic Peptide in Dyspnea Patients with Cardiogenic and Non-cardiogenic

Objective To investigate the differential diagnosis value of B-type natriuretic peptide in dyspnea patients with cardiogenic and non-cardiogenic dyspnea.Methods Forty-seven patients with dyspnea in the department of cardiology were included in this study.Patients were divided into two groups: dyspneic patients with cardiogenic and non-cardiogenic.Twenty-five healthy cases were selected as the control group.The concentration of BNP,LVEF was determined in all cases.We analyzed the relationship between BNP and LVEF.Furthermore we analyzed the relationship between BNP and the NYHA class.Results LVEF of the control group,dyspneic patients with cardiogenic and non-cardiogenic was(60.82 ±5.53)%,(55.92 ±5.62)% and(40.25 ±4.85)%.It had significant difference in the control group,dyspneic patients with cardiogenic and non-cardiogenic(P<0.01).BNP had significant difference in the control group,dyspneic patients withcardiogenic and non-cardiogenic(P<0.01).The concentration of BNP was positively corrlated with the NYHA class.The concentration of BNP was not statistically significant in control group and the group of dyspneic patients with non-cardiogenic(P>0.05).BNP was negatively correlated with LVEF.Conclusion The concentration of BNP is correlated with the NYHA class and LVEF.The concentration of BNP is a valuable standard for the identification of dyspnea with cardiogenic and non-cardiogenic.