论文部分内容阅读
目的 评估快速测定血浆B型钠尿肽(BNP)能否鉴别心源性与非心源性呼吸困难及判断充血性心力衰竭(CHF)预后。方法 应用快速检测方法测定249例呼吸困难患者的血浆BNP水平。由不知BNP测定结果的2名心内科医生判定临床诊断。结果 240例患者中呼吸困难单纯由CHF所致者131例,非CHF所致者64例,CHF与非CHF共同参与者45例,其BNP水平分别为(756±293)pg/ml,(48±21)pg/ml,(461±292)pg/ml组间比较差并有统计学意义(P<0.01)。BNP预测CHF的准确性为93％,优于各项临床指标。CHF患者心功能(NYHA)分级Ⅱ-Ⅳ级的BNP数值分别为(387±172)pg/ml,(694±321)pg/ml,(955±243)pg/ml,组间比较差异有统计学意义(P<0.01)。对CHF患者出院后随访6个月发现,有23例发生心血管事件,其BNP水平显著高于其他患者P<0.01。结论 快速测定血浆BNP有助于鉴别心源性与非心源性呼吸困难,并且BNP是一种判断CHF预后的客观性指标。
Objective To evaluate whether rapid determination of plasma B-type natriuretic peptide (BNP) can differentiate between cardiogenic and noncardiogenic dyspnea and predict the prognosis of congestive heart failure (CHF). Methods Rapid plasma BNP levels were measured in 249 patients with dyspnea using a rapid test. Two cardiologists who did not know the result of BNP test judged the clinical diagnosis. Results Among 240 patients, dyspnea was caused by CHF alone in 131 cases, non-CHF in 64 cases, and CHF and non-CHF in 45 cases with BNP levels of (756 ± 293) pg / ml and (48 ± 21) pg / ml, (461 ± 292) pg / ml were statistically significant (P <0.01). BNP predicted the accuracy of CHF was 93%, better than the clinical indicators. The BNP values of grade Ⅱ-Ⅳ of NYHA class were (387 ± 172) pg / ml, (694 ± 321) pg / ml, and (955 ± 243) pg / ml respectively in CHF patients with statistical difference Significance (P <0.01). After 6 months of follow-up of CHF patients, 23 patients had cardiovascular events and their BNP levels were significantly higher than those of other patients (P <0.01). Conclusion Rapid determination of plasma BNP can help identify dyspnea of cardiogenic and non-cardiac origin, and BNP is an objective index to judge the prognosis of CHF.