BNP 与 LVEF 诊断心功能不全的价值分析

目的探讨以呼吸困难为主诉的患者脑钠肽（BNP）及超声测定的左心室射血分数（LVEF）诊断心功能不全（CHF）的价值。方法对153例以急性呼吸困难为主诉的患者测定LVEF及BNP水平。结果153例患者诊断为CHF患者74例，非CHF患者79例，与非CHF组相比较，CHF组LVEF值显著降低，BNP水平显著升高，2组比较有显著性差异（P〈0．01）。以BNP≥100p g／mL或LVEF≤50％作为诊断CHF的切点，BNP诊断CHF的敏感性、特异性分别为80％和89％，LVEF诊断CHF的敏感性、特异性分别为62％和86％。二者结合做平行试验，则诊断CHF的敏感性提高至97％（P〈0．01）。结论与超声测定的LVEF相比较，血浆BNP水平诊断CHF具有较高的价值，若二者结合，诊断敏感性可进一步提高。

The value of B-type natriuretic peptide and LVEF in the diagnosis of congestive heart failure

Objective To assess the diagnostic performance of BNP testing and echocardiography assessment of left ventricular systolic function, separately and combined, for the identification of CHF in patients with acute dyspnea. Methods Echocardiographi determination of ejection fraction （EF） and measuring BNP of 153 patients with acute dyspnea were detected. Results All of the153 patients ,74 patients had a final diagnosis of CHF. Patients with CHF had a lower EF, and a higher BNP than patients without CHF. The sensitivity of BNP≥ 100 pg/mL forthe diagnosis of CHF was 80%, and specificity was 89%. Values for EF ≤50% had a sensitivity of 62% and a specificity of 86%.Combined the two methodes, the sensitivity was 97% .Conclusion BNP measurement is superior to two-dimensional echocardiographic determination EF in identifying CHF.The two methods combined have marked additive diagnostic value.