标题：BNP检测在急诊呼吸困难患者病因诊断及心功能评估中的意义

      作者：杨罡 1，王争君 2，朱琳燕 2，梁毅 2
    (1.鄂东医疗集团市中医医院内一科，湖北 黄石 435000；
2.鄂东医疗集团市中心医院心胸外科，湖北 黄石 435000)

      卷次： 2016年27卷13期

      【摘要】 目的 探讨脑钠肽(BNP)检测在急诊呼吸困难患者病因诊断及心功能评估中的意义。方法 回顾性
分析2014年3月至2015年6月因急诊呼吸困难在中医医院和中心医院治疗的100例患者的临床诊治资料，分析肺
源性（42例）和心源性呼吸困难(58例)患者的BNP水平，比较左心功能不全(32例)和右心功能不全(26例)以及不同
心功能等级患者BNP水平的差异。结果 心源性呼吸困难者BNP水平为(422.85±16.93) pg/mL，明显高于肺源性
呼吸困难患者的(162.38±15.42) pg/mL，差异具有显著统计学意义(P<0.01)；左心功能不全患者的 BNP水平为
(435.96±13.65) pg/mL，明显高于右心功能不全者的(372.32±15.31) pg/mL，差异具有统计学意义(P<0.05)；不同心功
能等级患者的BNP水平差异较大：心功能等级越高，BNP浓度越高，差异有统计学意义(P<0.05)；BNP浓度与每搏
输出量(SV)、左心室收缩压(LVPS)和左室射血分数(LVEF)呈负相关(r=-0.356、-0.362、-0.423)，与CTnl浓度呈正相
关(r=0.268，P<0.05)。结论 血清BNP浓度对急诊呼吸困难患者病因的判断具有较好的价值，并可初步判断患者
心功能情况，具有临床推广应用价值。

      【关键词】 脑钠肽；呼吸困难；心功能；肺源性；心源性；病因

      【中图分类号】 R605.97 【文献标识码】 A 【文章编号】 1003—6350（2016）13—2115—03


Clinical significance of BNP detection in the diagnosis of the etiology and cardiac function of patients with
dyspnea in emergency department.
YANG Gang 1, WANG Zheng-jun 2, ZHU Lin-yan 2, LIANG Yi 2. 1. Department of
Internal Medicine, Edong Healthcare City Hospital of Traditional Chinese Medicine, Huangshi 435000, Hubei, CHINA;
2. Department of Cardiothoracic Surgery, Huangshi Central Hosptial, Huangshi 435000, Hubei, CHINA

【Abstract】 Objective To investigate the clinical significance of brain natriuretic peptide (BNP detection in the
diagnosis of the etiology and cardiac function of patients with dyspnea in emergency department. Methods The cases
of 100 patients who underwent dyspnea in emergency department at our hospitals between March 2014 and June 2015
were analyzed in this study. The BNP levels of patients with pulmonary origin (n=42) and cardiac dyspnea (n=58) were
analyzed. The difference of BNP levels in patients with left ventricular dysfunction (n=32) and right ventricular dysfunc-
tion (n=26) was compared. Results The level of BNP in patients with cardiac dyspnea [(422.85±16.93) pg/mL] was sig-
nificantly higher than that of pulmonary dyspnea patients [(162.38±15.42) pg/mL] (t=-60.622, P<0.001). The level of
BNP in patients with left ventricular dysfunction [(435.96±13.65) pg/mL] was significantly higher than that of the right
·论 著·
6350.2016.13.018