[精品][經(jīng)典]血漿N-末端腦鈉肽前體質(zhì)量濃度對急性呼吸困難的診斷意義.doc

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1、［經(jīng)典］血漿N-末端腦鈉肽前體質(zhì)量濃度對急性呼吸困難的診斷意義血漿N-末端腦鈉肽前體質(zhì)量濃度對急性呼吸困難的診斷意義［摘耍］0的:探討血漿N-末端腦鈉肽前體(NT-proBNP)質(zhì)量濃度變化在急性心源性呼吸困難診斷和鑒別診斷中的臨床意義。方法:選取以呼吸困難為主訴來我院急診的患者110例，分為心源性呼吸困難組64例和非心源性呼吸困難組46例,采用酶聯(lián)免疫吸附法(ELTSA)檢測血漿NT-proBNP質(zhì)量濃度。結(jié)果：心源性呼吸困難組與非心源性呼吸困難組血漿NT-proBNP質(zhì)量濃度分別為(3641.48±2931.53)ng

2、•IT和(565.83±301.53)ng•IT,兩組間比較差異有統(tǒng)計學(xué)意義(P<0.01)。心源性呼吸困難組屮不同NYHA心功能分級的患者血漿NT-proBNP質(zhì)量濃度比較差異有統(tǒng)計學(xué)意義(P<0.01),心功能分級越差,NT-proBNP質(zhì)量濃度越高；以NT-proBNP質(zhì)量濃度600ng•I-l作為臨界值，血漿NT-proBNP質(zhì)量濃度對心源性呼吸困難診斷的敏感性很高(93.75%),但特異性略差(69.56%)。結(jié)論：快速檢測血漿NT-proBNP用來診斷心力衰竭特別是左心衰的方

3、法可靠、穩(wěn)定、敏感、快捷，可作為鑒別急性呼吸困難病因的一個重耍檢查方法。［關(guān)鍵詞］血漿N-末端腦鈉肽前體；心力衰竭；呼吸困難［中圖分類號］R441.8;R563.8［文獻標(biāo)識碼］A［文章編號］1671-7256(2011)02-0197-03doi：10.3969/j.issn.1671-7256.2011.02.024VaiueofplasmaNT-proBNPlevelsindiagnosinganddifferent!atinginacutedyspneapatientsZHOUBin,WANShao-bing,WA

4、NGYing(DepartmentofEmergency,theThirdHospitaiofWuhanCity,Hubei430060,China)［Abstract］Object!ve:ToinvestigatetheclinicalvalueoftheplasmaNT-proBNPlevelsinpatientswithacutecardiacdyspneaornoncardiacdyspnea?Methods：110patientswithacutedyspneaweredividedintotwogroups:c

5、ardiacdyspneagroup(64cases)andnoncardiacdyspneagroup(32cases)?TheplasmaNT-proBNPlevelwasmeasuredbyenzyme-linkediminunosorbentassay(ELISA)?Results:TheplasmaNT-proBNPlevelofthecaseswithcardiacdyspneaandnoncardiacdyspneawas(3641.48±2931.53)ng•L-land(565?83±301.

6、53)ng•L-1respectivelywithasignificantdifference(P<0.01).TheplasmaNT-proBNPlevelinthecaseswithdifferentclassesoftheNYHAheartfunctionwasalsosignificantlydifferent(P<0.01),andtheworseheartfunction,thehigherplasmaNT-proBNPlevelwas.If600ng•LTwastakenasacrit

7、icalvalue,theplasmaNT-proBNPlevelwasexcellentlysensitivefordiagnosingcardiacdyspnea(93.75%),butthespecificitywasnotverygood(69?56%)?Conclusion：TheplasmaNT-proBNPlevelishighlysensitivefordiagnosingcardiacdyspneaanddifferentiatingwithnoncardiacdyspnea,whichworksinac

8、onvenientrapidwayinclinic.[Keywords]NT-proBNP；heartfailure；dyspnea在醫(yī)院臨床急診工作中，以急性呼吸困難為主要癥狀的患者很多,且不少病例病情危重，快速診斷和鑒別診斷比較困難,較常見的原因有心源性呼吸困難比如急性心力衰竭、慢性心力衰竭急性加重