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目的通过检测小儿心源性呼吸困难和非心源性呼吸困难血清生物学标志物氨基末端B型利钠肽前体(NT-proBNP),探讨其在小儿呼吸困难鉴别诊断中的临床意义。方法测定以改良Ross评分诊断的心力衰竭患儿120例及其他原因导致的呼吸困难患儿40例的血清NT-proBNP,并进行对比,同时将根据改良的Ross评分将心力衰竭患者分为轻、中、重组。结果心源性呼吸困难患者的血清NT-proBNP明显高于非心源性呼吸困难患者,差异有统计学意义(P<0.01);心力衰竭患者各亚组组间对比差异有统计学意义(P<0.01),血清NT-proBNP浓度随着改良Ross评分的升高而升高,两者呈正相关。结论血清NT-proBNP的测定可以作为鉴别患者心源性呼吸困难及非心源性呼吸困难指标,且也可作为判断心力衰竭患者严重程度的指标。
Objective To investigate the clinical significance of detecting serum B-natriuretic peptide precursor (NT-proBNP) in children with cardiogenic dyspnea and non-cardiogenic dyspnea in differential diagnosis of respiratory dysfunction in children. Methods The serum levels of NT-proBNP in 120 children with heart failure diagnosed by modified Ross score and 40 children with dyspnea caused by other causes were measured and compared. At the same time, patients with heart failure were divided into mild, In the restructuring. Results Serum NT-proBNP in patients with cardiogenic dyspnea was significantly higher than that in non-cardiac dyspnea patients (P <0.01). There was significant difference between each subgroup of patients with heart failure (P <0.01). The serum concentration of NT-proBNP increased with the improvement of Ross score, which was positively correlated. Conclusion The determination of serum NT-proBNP can be used as an index to identify cardiogenic dyspnea and noncardiogenic dyspnea in patients, and can also be used as an index to determine the severity of heart failure.