Shao Le-wen, Han Yang, Wang Zhan-kun, Sun Jian
Advanced Ward Department, the First Affiliated Hospital, Medical School of Zhejiang University, Hangzhou 310003, China.
Zhonghua Nei Ke Za Zhi. 2005 Feb;44(2):99-101.
To investigate differential diagnoses value of ultra-rapid bedside measurement of brain natriuretic peptide (BNP) in patients with dyspnea.
Plasma BNP concentration were measured with immunofluorescence assay in 103 patients with dyspnea. Left ventricular ejection fraction (LVEF) and pulmonary capillary wedge pressure (PCWP) were determined by echocardiography and Swan-Ganz catheter in these patients on the same time, respectively.
(1) Plasma BNP levels in the patients with heart failure were higher than those in the non-heart failure patients [(716 +/- 86 vs 46 +/- 7) ng/L, P < 0.01]. (2) The sensitivity, specificity and negative predictive values of Plasma BNP levels > or = 100 pg/ml for predicting heart failure were 95.2% (60/63), 93.0% (40/43) and 97.1% (100/103), respectively. (3) Plasma BNP levels were positively related to PCWP, and negatively related to LVEF (r = -0.56, both P < 0.01).
Bedside BNP assay is sensitive and specific for diagnosing heart failure, and is useful in evaluating dyspnea in emergency care.
探讨超快速床旁检测脑钠肽（BNP）对呼吸困难患者的鉴别诊断价值。
采用免疫荧光法测定103例呼吸困难患者的血浆BNP浓度。同时分别用超声心动图和Swan - Ganz导管测定这些患者的左心室射血分数（LVEF）和肺毛细血管楔压（PCWP）。
（1）心力衰竭患者的血浆BNP水平高于非心力衰竭患者[（716±86对46±7）ng/L，P<0.01]。（2）血浆BNP水平≥100 pg/ml预测心力衰竭的敏感性、特异性和阴性预测值分别为95.2%（60/63）、93.0%（40/43）和97.1%（100/103）。（3）血浆BNP水平与PCWP呈正相关，与LVEF呈负相关（r = -0.56，均P<0.01）。
床旁BNP检测对心力衰竭的诊断具有敏感性和特异性，有助于急诊中对呼吸困难的评估。
