• 玉林市第一人民醫(yī)院心內(nèi)科(廣西玉林 537000);

【摘要】 目的 探討血漿腦鈉素(BNP)水平對心源性呼吸困難的診斷價值。方法 采用特異性放射免疫法測定慢性心力衰竭(CHF)引起的呼吸困難患者(n=52)和非CHF引起呼吸困難患者(n=30),以及健康志愿者(正常對照組,n=28)血漿BNP濃度,并進(jìn)行組間比較。結(jié)果 CHF組BNP濃度均顯著高于非CHF組及正常對照組[(649.80±141.72)pg/mL比(59.08±18.60)pg/mL和(65.20±16.32)pg/mL,P lt;0.05],而非CHF組與正常對照組BNP濃度無顯著差異,不同NYHA心功能分級患者的血漿BNP濃度隨心功能級別增加而顯著增高,CHF患者血漿BNP濃度與左室射血分?jǐn)?shù)(LEVF)水平呈顯著負(fù)相關(guān)(r=-0.673,P lt;0.001)。受試者工作特征曲線(ROC曲線)下面積為0.91(0.88~0.98,P lt;0.001),最佳界值(206 pg/mL)時的敏感性、特異性、陽性預(yù)測值和陰性預(yù)測值分別為87.2%,86.8%,84.2%和91.8%。結(jié)論 血漿BNP是診斷心源性呼吸困難的一項很有價值的指標(biāo)。

引用本文: 姚光,藍(lán)海云. 腦鈉素對心源性呼吸困難的診斷價值. 中國呼吸與危重監(jiān)護雜志, 2007, 6(1): 52-54. doi: 復(fù)制

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2. Cabanes L,Richaud-Thiriez B,F(xiàn)ulla Y,et al.Brain natriuretic peptide blood levels in the differential diagnosis of dyspnea.Chest,2001,120:2047-2050.
3. 陳協(xié)興,洪華山,王一波,等.腦鈉素在慢性心力衰竭診斷、預(yù)后評估中的價值.中國循環(huán)雜志,2003,18:434-436.
4. Krishnaswamy P,Lubien E,Clopton P,et al.Utility of B-natriuretic peptide levels in identifying patients with left ventricular systolic or diastolic dysfunction.Am J Med,2001,111:274-279.
5. Lubien E,DeMaria A,Krishnaaswamy P,et al.Utility of B-natriuretic peptide in detecting diastolic dysfunction:comparison with Doppler velocity recordings.Circulation,2002,105:595-601.
6. 吳彥,胡大一.B型腦鈉素評價急性呼吸困難研究.中國醫(yī)刊,2003,10:62-63.
7. Mueller C,Laule-Kilian K,Christ A,et al.The use of B-type natriuretic peptide in the diagnosis of acute dyspnoea.Clin Lab,2005,51:5-9.
8. 黃培志,童朝陽,顧國榮,等.呼吸困難患者快速檢測腦鈉素的意義.上海醫(yī)學(xué),2005,28:61-63.
9. 曹向紅,王鳳芝,曹俊杰,等.血漿腦鈉素在心源性和肺源性呼吸困難鑒別診斷中的價值.中國藥物與臨床,2004,4:116-119.
10. Maisel AS,Krishnaswamy P,Nowak RM,et al.Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure.N Engl J Med,2002,347:161-167.
11. 陳協(xié)興,洪華山,王一波,等.慢性心力衰竭患者血清腦利鈉肽水平的變化及其臨床意義.中華臨床藥理學(xué)與治療學(xué),2003,8:631-634.
  1. 1. McDonagh TA,Robb SD,Murdoch DR,et al.Biochemical detection of left ventricular systolic dysfunction.Lancet,1998,351:9-13.
  2. 2. Cabanes L,Richaud-Thiriez B,F(xiàn)ulla Y,et al.Brain natriuretic peptide blood levels in the differential diagnosis of dyspnea.Chest,2001,120:2047-2050.
  3. 3. 陳協(xié)興,洪華山,王一波,等.腦鈉素在慢性心力衰竭診斷、預(yù)后評估中的價值.中國循環(huán)雜志,2003,18:434-436.
  4. 4. Krishnaswamy P,Lubien E,Clopton P,et al.Utility of B-natriuretic peptide levels in identifying patients with left ventricular systolic or diastolic dysfunction.Am J Med,2001,111:274-279.
  5. 5. Lubien E,DeMaria A,Krishnaaswamy P,et al.Utility of B-natriuretic peptide in detecting diastolic dysfunction:comparison with Doppler velocity recordings.Circulation,2002,105:595-601.
  6. 6. 吳彥,胡大一.B型腦鈉素評價急性呼吸困難研究.中國醫(yī)刊,2003,10:62-63.
  7. 7. Mueller C,Laule-Kilian K,Christ A,et al.The use of B-type natriuretic peptide in the diagnosis of acute dyspnoea.Clin Lab,2005,51:5-9.
  8. 8. 黃培志,童朝陽,顧國榮,等.呼吸困難患者快速檢測腦鈉素的意義.上海醫(yī)學(xué),2005,28:61-63.
  9. 9. 曹向紅,王鳳芝,曹俊杰,等.血漿腦鈉素在心源性和肺源性呼吸困難鑒別診斷中的價值.中國藥物與臨床,2004,4:116-119.
  10. 10. Maisel AS,Krishnaswamy P,Nowak RM,et al.Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure.N Engl J Med,2002,347:161-167.
  11. 11. 陳協(xié)興,洪華山,王一波,等.慢性心力衰竭患者血清腦利鈉肽水平的變化及其臨床意義.中華臨床藥理學(xué)與治療學(xué),2003,8:631-634.