CAJ | 학술논문

目的评价血浆脑利钠肽(BNP)水平在心源性和肺源性呼吸困难时鉴别诊断的价值.方法采用美国拜尔公司生产的化学发光检测仪及其BNP试剂,检测248例因呼吸困难住院的肺疾病患者血浆BNP水平,对单纯肺疾病患者、肺疾病并发左心功能不全患者、肺疾病未并发左心功能不伞患者、肺疾病并发右心衰患者各组间BNP水平进行比较.结果肺疾病并发左心功能不全的呼吸困难患者的BNP水平明显高于未并发左心功能不全的呼吸困难患者(x2=25.597,P<0.001);肺疾病并发右心衰患者BNP水平高于单纯肺疾病患者,但差异没有统计学意义(t=1.614,P0.05);肺疾病并发左心功能不全患者的BNP水平明显高于肺疾病并发右心衰患者(t=2.531,P<0.05);肺疾病并发左心功能不全患者的心功能越差,BNP水平就越高,心功能Ⅱ、Ⅲ、Ⅳ级三组间BNP水平的差别有统计学意义(x2=29.463,P<0.001).结论血浆BNP是快速鉴别诊断心源性和肺源性呼吸困难的重要实验窜检测指标,同时可判断肺疾病并发左心功能不全患者心衰的严重程度.
목적 평개혈장뇌리납태(BNP)수평재심원성화폐원성호흡곤난시감별진단적개치.방법 채용미국배이공사생산적화학발광검측의급기BNP시제,검측248례인호흡곤난주원적폐질병환자혈장BNP수평,대단순폐질병환자、폐질병병발좌심공능불전환자、폐질병미병발좌심공능불산환자、폐질병병발우심쇠환자각조간BNP수평진행비교.결과 폐질병병발좌심공능불전적호흡곤난환자적BNP수평명현고우미병발좌심공능불전적호흡곤난환자(x2=25.597,P<0.001);폐질병병발우심쇠환자BNP수평고우단순폐질병환자,단차이몰유통계학의의(t=1.614,P0.05);폐질병병발좌심공능불전환자적BNP수평명현고우폐질병병발우심쇠환자(t=2.531,P<0.05);폐질병병발좌심공능불전환자적심공능월차,BNP수평취월고,심공능Ⅱ、Ⅲ、Ⅳ급삼조간BNP수평적차별유통계학의의(x2=29.463,P<0.001).결론 혈장BNP시쾌속감별진단심원성화폐원성호흡곤난적중요실험찬검측지표,동시가판단폐질병병발좌심공능불전환자심쇠적엄중정도.
Objective To evaluate the value of plasma brain natriuretic peptide (BNP)level for differentiating cardiogenic dyspnea from pulmogenic dyspnea.Methods The detection of plasma BNP was carried out in 248 patients with dyspnea.The apparatus was the CENTUR type chemiluminescence detection produced by the Bayer companies of USA.All patients were divided into three groups depending on disease severity.The level of plasma BNP in each group was compared.Results The level of plasma BNP in pulmonary disease complicated with left ventricular dysfunction was higher than that of pulmonary disease non-complicated with left ventricular dysfunction.There was significant difference between two groups(x2=25.597,P<0.001).The level of plasma BNP in pulmonary disease complicated with right ventricular dysfunction was higher than that of simple pulmonary disease.There was no significant difference between two groups (t=1.614,P0.05 ).The level of plasma BNP in pulmonary disease complicated with left ventricular dysfunction was higher than that of pulmonary disease complicated with right ventricular dysfunction.There was significant difference between two groups (t=2.531,P<0.05).If the left ventricular dysfunction degree was notable,the level of plasma BNP was high.There was also significant difference in different cardiac function classification by New York Heart Association (X2=29.463,P<0.001).Conclusion Plasma BNP analysis is an importent method for differentiating cardiogenic dyspnea from pulmogenic dyspnea.Meanwhile,it is also helpful to evaluating the severity of pulmonary disease complicated with left ventricular dysfunction.