N末端B型利钠肽原检测对急性呼吸困难鉴别诊断的临床价值.docVIP

N末端B型利钠肽原检测对急性呼吸困难鉴别诊断的临床价 仲腊春 （江苏省灌南县人民医院检验科江苏连云港222500） 【摘要】目的：探讨N末端B型利钠肽原（NT-proBNP）检测对急性呼吸 困难的鉴别诊断价值。方法：将328例急性呼吸困难患者，根据临床诊断分为急 性充血性心力衰竭组（急性心衰组）176例及非心衰组152例,比较两组患者初入院 时的NT-proBNP水平，评价其对急性呼吸困难鉴别诊断的价值。结果：急性心衰 组及非心衰组NT-proBNP浓度分别为3184.4plusmn;1638.3 pg/mL和 388.6plusmn;154.7pg/mL,两组比较差异具有显著性意义（P0.01）。以 NT-proBNPge;1500pg/mL为心力衰竭阳性诊断[1],诊断急性充血性心力衰竭的灵 敏度为92.0%,特异性为90.1%,阳性预测值为91.5%,阴性预测值为90.7%,诊 断效率达91.2%。结论：急诊常规检测NT-proBNP有利于对急性呼吸困难患者做 出快速诊断，有助于鉴别急性呼吸困难是否为急性充血性心力衰竭所致。 【关键词】N末端B型利钠肽原；急性呼吸困难；心力衰竭；鉴别诊断 【屮图分类号】R446 【文献标识码】A 【文章编号】1007-8231 （2015） 11-0017-02 Detection of N terminal B type natriuretic peptide on the clinical value of differential diagnosis of acute dyspnea Zhong Lachun. Guannan County people’s Hospital of Jiangsu Province.225OO.China 【Abstract】Objective Study on detection of N terminal B type natriuretic peptide on the clinical value of differential diagnosis of acute dyspnea. Methods 328 cases of acute dyspnea were divided into 176 cases with acute congestive heart failure and 152 cases with non heart failure group according to the clinical diagnosis,The NT- BNP level of two groups of patients were compared,and the value of the differential diagnosis of acute dyspnea was evaluated.Results NT- BNP concentrations in acute heart failure group and non heart failure group were significantly different between 3184.4plusmn;1638.3 pg/mL and 388.6plusmn;154.7pg/mL two groups (P 0.01).NT-proBNPge;1500 pg/mL for heart failure diagnosis ,the sensitivity of diagnosis of acute congestive heart failure was 92.0%,the specificity was 90.1%,the positive predictive value was 91.5%, the negative predictive value was90.7%, the diagnostic efficiency was 91.2%.Conclusion Routine detection of NT-proBNP is helpful for making rapid diagnosis of acute dyspnea ,and it can be helpful to identify acute respiratory difficulties and whether it is caused by acute congestive heart failure. 【Key words]N terminal B type natriuretic peptide; Acute dyspnea; Heart failure; Differential diagn