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目的:探讨B型利钠肽(Btypenatriureticpeptide,BNP)用于甄别急诊呼吸困难中的充血性心力衰竭(congestiveheartfailure,CHF)的早期诊断意义。方法:130例急诊呼吸困难患者,根据临床资料及左心室射血分数(leftventricularejectionfraction,LVEF)分为CHF组(78例)和非CHF组(52例)。采用干式快速免疫荧光法定量分析检测血液中的BNP浓度。结果:CHF组BNP浓度为(732±53)ng/L,显著高于非CHF组的(71±34)ng/L(P<0.01);以BNP100ng/L作为阈值区分呼吸困难是否为CHF所致,其敏感度、特异度、准确性分别为92%、96%、93%;在CHF组中,BNP浓度在不同心功能级别之间差异有统计学意义(P<0.01),随心功能不全加重而升高。猝死者的BNP值高于存活者。结论:BNP水平对于CHF的诊断具有较高的灵敏度、特异度和准确性。对于鉴别呼吸困难是否为心源性具有重要意义。
Objective: To investigate the early diagnostic significance of Btypenatriuretic peptide (BNP) for screening congestive heart failure (CHF) in emergency dyspnea. Methods: 130 patients with dyspnea were divided into CHF group (78 cases) and non-CHF group (52 cases) according to the clinical data and left ventricular ejection fraction (LVEF). Quantitative analysis of BNP in blood by dry-fast immunofluorescence assay. Results: BNP concentration in CHF group was (732 ± 53) ng / L, significantly higher than that in non-CHF group (71 ± 34 ng / L, P <0.01) The sensitivity, specificity and accuracy were 92%, 96% and 93% respectively. In the CHF group, there was a significant difference in BNP concentration between different cardiac function levels (P <0.01) Increased and increased. Sudden death of BNP value higher than those who survived. Conclusion: BNP level has high sensitivity, specificity and accuracy for the diagnosis of CHF. For the identification of dyspnea is of cardiogenic significance.