观察肺源性呼吸困难与心源性呼吸困难患者中的脑钠肽水平-内科学(呼吸病学)专业论文.docxVIP

— —1— 摘 要 观察肺源性呼吸困难与心源性呼吸困难 患者中的脑钠肽水平 研究生：燕存子 导师：加孜那·托哈依 副教授 摘 要 目的：探讨脑钠肽(BNP)水平高低是否在鉴别肺源性呼吸困难及心源性呼吸困难 中有意义，为临床提供更多的诊断信息。方法：选择 2008 年 12 月-2009 年 12 月有 呼吸困难临床表现的患者 124 例及相关临床资料。根据病史、体格检查、辅助检查 综合判断为呼吸系统相关疾病和心血管相关疾病，分为肺源性呼吸困难组 50 例和心 源性呼吸困难组 74 例。比较两组间脑钠肽水平高低及评价与左心射血分数、肺动脉 压力、动脉血氧分压之间的相关性。结果：1.心源性呼吸困难组 BNP 平均水平为 2390.39 ± 600.62pg/ml ，明显高于肺源性呼吸困难组 BNP 平均水平 965.40 ± 487.22pg/ml，两组间统计学有差异(P0.05)。2. BNP 水平与动脉血氧分压(PaO2)在心 源性呼吸困难组 r 为-0.49 P0.05)及肺源性呼吸困难组 r 为-0.59，P0.05。均有良好 的相关性。在心源性呼吸困难组 BNP 与左心射血分数有显著的相关性 r 为-0.59， P0.05。在肺源性呼吸困难组 BNP 水平与肺动脉压力相关性显著 r 为 0.44，P0.05。 结论：1 心源性呼吸困难组 BNP 水平明显高于肺源性呼吸困难组；2 动脉血氧分压 (PaO2)与心源性呼吸困难组和肺源性呼吸困难组均呈负相关，且相关性均显著。3 BNP 水平与射血分数呈负相关，对心衰的诊断有意义。4. 肺源性呼吸困难组中 BNP 水平与肺动脉压力呈正相关，肺动脉压力越高，则 BNP 数值越高。 关键词：脑钠肽；肺源性呼吸困难；心源性呼吸困难 新疆医科大学医学硕士学位论文 Observe pro-BNP in differential dyspnea which caused by heart disease or pulmonary disease Postgraduate:Yan Cunzi Supervisor:prof.Jia Zina Abstract Objective: To investigate the value of pro-BNP in the differential diagnosis of dyspnea caused by heart disease or pulmonary disease in order to provide clinical diagnostic information. Methods: Choice 124 patients with dyspnea symptom from December 2008 to December 2009.The pro-BNP of patients suffered from dyspnea which caused by heart failure or pulmonary disease were measured by radioimmunoassay and compared the results. There were 124 subjects, including 74 patients suffered dyspnea which caused by heart failure and 50 patients suffered dyspnea which caused by pulmonary disease. All of them underwent right heart function test, pulmonary artery pressure (PAP) and blood gas analysis. Compare the plasma BNP level in the two groups with ejection fraction, PAP and PaO2. Results:1.The pro-BNP level of the patients who dyspnea were caused by heart disease 2390.39±600.62 pg/mL were obviously higher than those of patients whose dyspnea were caused by pulmonary disease 965.40±487.22 pg/mL (P 0. 05). 2. The plasma BNP level was positively correlated with ejection fraction, PAP