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目的:探讨血浆N-末端脑钠肽前体(NT-proBNP)水平变化在急性心源性呼吸困难(心力衰竭)与非心源性呼吸困难患者中诊断和鉴别诊断的临床意义。方法:选取以呼吸困难为主诉来我院急诊的患者110例,分为心源性呼吸困难组64例,非心源性呼吸困难组46例,采用酶联免疫吸附法(ELISA)检测血浆NT-proBNP水平。结果:心源性呼吸困难各亚组与非心源性呼吸困难组血浆NT-proBNP水平差异有统计学意义(P<0.01);心源性呼吸困难组中不同NYHA心功能分级的患者血浆NT-proBNP水平差异有统计学意义(P<0.01),心功能分级越差,NT-proBNP水平越高;以NT-proBNP水平600ng/L作为临界值,血浆NT-proBNP水平对于心源性呼吸困难诊断的敏感性很高(93.75%),但特异性略差(69.56%)。结论:快速检测血浆NT-proBNP用来诊断心力衰竭特别是左心衰可靠、稳定、敏感、快捷,可作为急性呼吸困难病因鉴别的一个重要检查方法。
Objective: To investigate the clinical significance of the changes of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in the diagnosis and differential diagnosis of patients with acute cardiogenic dyspnea (heart failure) and noncardiogenic dyspnea. Methods: A total of 110 emergency patients admitted to our hospital with dyspnea were selected. They were divided into cardiogenic dyspnea group (n = 64) and noncardiogenic dyspnea group (n = 46). Enzyme-linked immunosorbent assay (ELISA) -proBNP level. Results: There was significant difference in plasma NT-proBNP levels between each subgroup of cardiogenic dyspnea and noncardiogenic dyspnea group (P <0.01). In patients with different types of cardiac dysfunction, (P <0.01). The worse the grade of heart function was, the higher the level of NT-proBNP. At the level of NT-proBNP of 600 ng / L, the plasma NT-proBNP level was significantly different from that of cardigenic dyspnea The diagnostic sensitivity was high (93.75%), but the specificity was slightly worse (69.56%). Conclusion: Rapid detection of plasma NT-proBNP is a reliable, stable, sensitive and rapid method for the diagnosis of heart failure, especially left heart failure. It can be used as an important method to identify the cause of acute dyspnea.