【摘要】 目的探讨血浆脑钠素(BNP)水平对心源性呼吸困难的诊断价值。方法采用特异性放射免疫法测定慢性心力衰竭(CHF)引起的呼吸困难患者(n=52)和非CHF引起呼吸困难患者(n=30),以及健康志愿者(正常对照组,n=28)血浆BNP浓度,并进行组间比较。结果CHF组BNP浓度均显著高于非CHF组及正常对照组[(649.80±141.72)pg/mL比(59.08±18.60)pg/mL和(65.20±16.32)pg/mL,P<0.05],而非CHF组与正常对照组BNP浓度无显著差异,不同NYHA心功能分级患者的血浆BNP浓度随心功能级别增加而显著增高,CHF患者血浆BNP浓度与左室射血分数(LEVF)水平呈显著负相关(r=-0.673,P<0.001)。受试者工作特征曲线(ROC曲线)下面积为0.91(0.88~0.98,P<0.001),最佳界值(206pg/mL)时的敏感性、特异性、阳性预测值和阴性预测值分别为87.2%,86.8%,84.2%和91.8%。结论血浆BNP是诊断心源性呼吸困难的一项很有价值的指标。更多还原

【Abstract】 Objective To evaluate the diagnostic value of brain natriuretic peptide (BNP) for cardiac dyspnea.Methods Plasma BNP levels were measured by radioimmunoassay in dyspnea patients with chronic heart failure (CHF) (n=52) or without CHF (n=30) and normal control group (n=28).Results The BNP level in dyspnea patients with CHF was significantly higher than that of dyspnea patients without CHF and normal control group [(649.80±141.72) pg/mL vs (59.08±18.60) pg/mL and (65.20±16.32) pg/mL,respectively,P<0.05].There was no significant difference of BNP level between dyspnea patients without CHF and normal group (P>0.05).The plasma BNP level elevated with the worsening of heart failure (NYHA Classiffication).The BNP level in dyspnea patients with CHF was negatively correlated with left ventricle ejection fraction (r=-0.673,P<0.001).The receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve (AUC) is 0.91(0.88-0.98,P<0.001) with a sensitivity of 87.2% and a specificity of 86.8% at the cutoff value of 206 pg/mL.Conclusion Measurement of plasma BNP is a rapid diagnostic method for cardiac dyspnea.更多还原