标题：氨基末端-B型脑钠肽水平测定在肺源性与心源性呼吸困难中的鉴别意义

      作者：容永璋，陈林祥，徐美玲
    （江门市人民医院重症医学科，广东 江门 529051）

      卷次： 2013年24卷12期

      【摘要】 目的 探讨氨基末端-B型脑钠肽（NT-proBNP）水平的测定在肺源性与心源性呼吸困难鉴别诊断的临
床意义。方法 选取我院ICU收治的肺源性呼吸困难33例，心源性呼吸困难48例，比较分析两组患者的临床资料及
其NT-proBNP水平。选择同期心内科住院心功能正常的50例患者进行对照。结果 NT-proBNP水平在肺源性呼
吸困难和心源性呼吸困难中分别为(610±293) pg/ml和(3 263±384) pg/ml，其差异具有显著统计学意义(P<0.01)，与
对照组[(152±201) pg/ml]比较差异有显著统计学意义(P均<0.01)，且在心源性呼吸困难组中NYHA心功能分级Ⅲ、
Ⅳ级的NT-proBNP水平差异亦存在统计学意义(P<0.05)，心功能越差，NT-proBNP越高。结论 NT-proBNP测定对
肺源性及心源性呼吸困难的鉴别有重要意义，对心功能不全程度评定也有一定价值。

      【关键词】 N端B型脑钠肽；肺源性呼吸困难；心源性肺水肿

      【中图分类号】 R541.6 【文献标识码】 A 【文章编号】 1003—6350（2013）12—1770—03


Value of NT-proBNP levels in the differential diagnosis of pulmonary and cardiac dyspnea.
RONG Yong-zhang,
CHEN Lin-xiang, XU Mei-ling. Intensive Care Unit (ICU), People's Hospital of Jiangmen, Jiangmen 529051,
Guangdong, CHINA

【Abstract】 Objective To investigate the value of NT-proBNP levels in the differential diagnosis of pulmo-
nary and cardiac dyspnea. Methods Thirty-three patients with pulmonary dyspnea (group A) and 48 patients with
cardiac dyspnea (group B) in ICU were enrolled in the study. The clinical data and the plasma NT-proBNP levels were
compared between the two groups. Fifty patients with normal cardiac function from Department of Cardiology were
selected as the control group. Results The plasma NT-proBNP level was (610±293) pg/ml in group A and (3 263±
384) pg/ml in group B, with statistically significant difference between the two groups (P<0.01). The plasma NT-proB-
NP level in the control group was (152±201) pg/ml, showing marked significant difference with group A and group B
(P<0.01). In group B, the plasma NT-proBNP level showed significant difference between NYHAⅢ and NYHAⅣ
(P<0.05). The poorer the heart function, the higher the plasma NT-proBNP level. Conclusion The plasma NT-proB-
NP level play an important role to differentiate pulmonary dyspnea from cardiac dyspnea, which has certain clinical
significance in evaluating the degree of cardiac insufficiency.

      【Key words】 NT-proBNP; Pulmonary dyspnea; Cardiogenic pulmonary edema
基金项目：江门市科技局课题（编号：jk2010-7407）