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目的探讨B型钠尿肽(Btypenatriureticpeptide)对充血性心力衰竭患者急性呼吸困难的鉴别诊断意义。方法选择130例急性呼吸困难患者,根据临床资料及左室射血分数分为充血性心力衰竭组78例、非充血性心力衰竭组52例。采用干式快速免疫荧光定量分析法检测血浆中的B型钠尿肽浓度。结果充血性心力衰竭组血浆B型钠尿肽浓度为(732±53)ng/L,高于非充血性心力衰竭组的(71±34)ng/L(P<0.01);以B型钠尿肽100ng/L作为阈值区分呼吸困难是否为充血性心力衰竭所致,其敏感性、特异性和准确性分别为92.30%、94.23%和93.07%;在充血性心力衰竭组,B型钠尿肽浓度在心功能不同级别(美国纽约心脏病学会心功能分级Ⅱ、Ⅲ和Ⅳ级)之间差异有统计学意义(P<0.01)。血浆B型钠尿肽>500ng/L常预示猝死发生。结论血浆B型钠尿肽水平对于充血性心力衰竭的诊断具有较高的敏感性、特异性和准确性,对于鉴别呼吸困难是否为心源性具有重要参考意义。
Objective To investigate the differential diagnosis significance of B-type natriuretic peptide (Btypenatriuretic peptide) on acute dyspnea in patients with congestive heart failure. Methods A total of 130 patients with acute dyspnea were selected. According to clinical data and left ventricular ejection fraction, they were divided into congestive heart failure group (n = 78) and non-congestive heart failure group (n = 52). The concentration of B-type natriuretic peptide in plasma was measured by dry-fast immunofluorescence quantitative analysis. Results The concentration of plasma B-type natriuretic peptide in patients with congestive heart failure was (732 ± 53) ng / L, higher than that in patients without congestive heart failure (71 ± 34) ng / L (P <0.01) The sensitivity, specificity and accuracy of urinary peptide 100ng / L as a threshold to discriminate whether dyspnea was congestive heart failure were 92.30%, 94.23% and 93.07%, respectively. In congestive heart failure group, Peptide concentrations at different levels of cardiac function (New York Heart Association Society of Cardiac Function grade Ⅱ, Ⅲ and Ⅳ) between the differences were statistically significant (P <0.01). Plasma B-type natriuretic peptide> 500ng / L often indicates sudden death. Conclusions Plasma B-type natriuretic peptide level has high sensitivity, specificity and accuracy for the diagnosis of congestive heart failure, which is of important reference significance for differentiating whether or not dyspnea is cardiogenic.