CAJ | 학술논문

目的：探讨血清脑钠肽（Brain Natriuretic Peptide，BNP）在鉴别心源性呼吸困难和非心源性呼吸困难中的临床意义。方法68例呼吸困难患者随机分为心源性呼吸困难组和非心源性呼吸困难组各34例，测定患者的血清BNP和左心室射血分数（Left Ventricular Ejection Fraction， LVEF），并进行对照研究。结果心源性呼吸困难组的血清BNP及LVEF分别为450.82±7.04pg/ml、55.54±8.71%，非心源性呼吸困难组的血清B N P及L V E F分别为74.36±11.23p g/m l、67.64±6.50%；心源性呼吸困难组患者的B N P明显高于非心源性呼吸困难组的患者，而L V E F值明显低于非心源性呼吸困难组的患者，差异均有统计学意义。心源性呼吸困难组中：11例心功能Ⅱ级组患者的血清BNP及LVEF分别为312.03±12.80pg/ml、61.00±6.00%，11例心功能Ⅲ级组患者的血清BNP及LVEF分别为446.39±13.22pg/ml、52.00±7.00%，12例心功能Ⅳ级组患者的血清BNP及LVEF分别为678.25±14.54pg/ml、43.00±8.00%；心功能Ⅱ级组患者的BNP水平明显低于心功能Ⅲ级组患者，LVEF明显高于心功能Ⅲ级组患者；心功能Ⅲ级组患者的BNP水平也明显低于心功能Ⅳ级组患者，LVEF也明显高于心功能Ⅳ级组患者。结论脑钠肽可以辅助鉴别心源性和非心源性呼吸困难患者。
목적：탐토혈청뇌납태（Brain Natriuretic Peptide，BNP）재감별심원성호흡곤난화비심원성호흡곤난중적림상의의。방법68례호흡곤난환자수궤분위심원성호흡곤난조화비심원성호흡곤난조각34례，측정환자적혈청BNP화좌심실사혈분수（Left Ventricular Ejection Fraction， LVEF），병진행대조연구。결과심원성호흡곤난조적혈청BNP급LVEF분별위450.82±7.04pg/ml、55.54±8.71%，비심원성호흡곤난조적혈청B N P급L V E F분별위74.36±11.23p g/m l、67.64±6.50%；심원성호흡곤난조환자적B N P명현고우비심원성호흡곤난조적환자，이L V E F치명현저우비심원성호흡곤난조적환자，차이균유통계학의의。심원성호흡곤난조중：11례심공능Ⅱ급조환자적혈청BNP급LVEF분별위312.03±12.80pg/ml、61.00±6.00%，11례심공능Ⅲ급조환자적혈청BNP급LVEF분별위446.39±13.22pg/ml、52.00±7.00%，12례심공능Ⅳ급조환자적혈청BNP급LVEF분별위678.25±14.54pg/ml、43.00±8.00%；심공능Ⅱ급조환자적BNP수평명현저우심공능Ⅲ급조환자，LVEF명현고우심공능Ⅲ급조환자；심공능Ⅲ급조환자적BNP수평야명현저우심공능Ⅳ급조환자，LVEF야명현고우심공능Ⅳ급조환자。결론뇌납태가이보조감별심원성화비심원성호흡곤난환자。
Objective To investigate the clinical function of Brain Natriuretic Peptide in cardiac and non-cardiac dyspnea identification. Method 68 patients with dyspnea were randomly divided into cardiac dyspnea group and non-cardiac dyspnea group, each group were 34 cases. The brain natriuretic peptide and left ventricular ejection fraction of 68 patients were surveyed, evaluated,and juxtaposed studied. Results The brain natriuretic peptide and left ventricular ejection fraction of cardiac dyspnea group were respectively 450.82 ± 7.04pg/ml and 55.54 ± 8.71 percent, while the brain natriuretic peptide and left ventricular ejection fraction of non-cardiac dyspnea were respectively 74.36±11.23pg/ml and 67.64±6.50 percent. The brain natriuretic peptide of patients with cardiac dyspneain were significantly higher than those of patients with non-cardiac dyspneain, while the left ventricular ejection fraction of cardiac dyspnea group were lower than those of patients with non-cardiac dyspnea,the differences were statistical y significant. Among cardiac dyspnea group,the brain natriuretic peptide and left ventricular ejection fraction of 11 patients with cardiac function Ⅱ grade were respectively 312.03 ± 12.80pg/ml and 61.00 ± 6.00 percent, the brain natriuretic peptide and left ventricular ejection fraction of 11 patients with cardiac function Ⅲ grade were respectively 446.39±13.22 pg/ml and 52.00±7.00 percent, the brain natriuretic peptide and left ventricular ejection fraction of 12 patients with cardiac function Ⅳ grade were respectively 678.25±14.54 pg/ml and 43.00±8.00 percent. The brain natriuretic peptide of patients with cardiac function Ⅱ grade were evidently lower than those of cardiac function Ⅲ grade,while the left ventricular ejection fraction were obviously higher than patients with cardiac function class Ⅲ group;the brain natriuretic peptide of patients with cardiac function Ⅲ grade were clearly lower than those of cardiac function Ⅳ grade,while the left ventricular ejection fraction were distinctly higher than patients with cardiac function class Ⅳgroup. Conclusion Brain natriuretic peptide can assist the identification of cardiac and non-cardiac dyspnea.