血浆脑钠素在心原性和肺原性呼吸困难鉴别诊断中的意义

《血浆脑钠素在心原性和肺原性呼吸困难鉴别诊断中的意义》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。

1、山西医科大学硕士学位论文血浆脑钠素在心原性和肺原性呼吸困难鉴别诊断中的意义姓名：曹向红申请学位级别：硕士专业：心血管内科指导教师：王凤芝2003.6.2m浆脑钠索在心原性和肺原性呼吸困难鉴别诊断中的意义血浆脑钠素在心原性和肺原性呼吸困难鉴别诊断中的意义摘要弱的谬份血浆脑锄素(8NP)浓度测定在急姓呼吸困难患者中对左心衰竭的诊断价值。方法运用免疫放射测量方法测定79镶急性呼吸隧难惑者盘浆BNP浓度，根据临床表现、楣关检查及对不圊治疗的反应确定呼吸困难的主要原因(左心衰竭、肺心瘸和单纯肺部疾病)，并以此为标准评价皿浆BNP浓度测定对左心衰

2、竭的诊断份值。结果左心衰竭缝(n=34>照浆BNP浓度(615±392pg抽1)显著离子单纯肺病缎(n=24，60±46pg／llll)和肺心病组(舻2j，183±145pg／111I)(p均<0．00l>。鼓210pg细l为界僮，盘浆BNp浓度溯定诊舔左心衰竭的准确度为87。4％，阴性预测值为90+7％。受试者工作特征曲线(ROC曲线)下面积为0．93(O．88，0．99，p<0．001)。多因索分轿表赞巍浆BNp浓度溯定怒左心衰竭醛独立的强有力淤诊断指标，在常规检查届测定血浆BNp浓度可显著提高诊断准确度。结论在恕性严遵呼吸困难患

3、者血浆BNP浓度测定蹩一敏感覆虽特舅的左心衰竭诊断方法。【关键词】脑钠素；呼吸豳难；左心衰竭血浆脑钠紊在心原性和肺原性呼吸困难鉴别诊断中的意义Utilityofbrainnatriureticpeptideindif扎rentiatingleftheartfailurefromlungdiseaseinpatientspresentingwithdyspnea．【abstract】objectiveThegoaloflhisstudywastoevaluatetheut订ityofIneasurementofbraillnatriur

4、eIicpeptide(BNP)inthediagnosisofleftheartf．aihlre(LHF)inpatientspresentingwithdyspnea．MethodsBNPpIasmaconcentrationswere1neasuredin79in—patientswithdyspnea．Themaincausesofdyspneaweredeterminedaccordingtoclinicaldataincludingsymptoms，physicalsigns，resultsoffhrthercardiac

5、andpulmonarytestsandresponsestospecialtreatmentsanddividedintothreecatego“es(LHF，corpuIlnonaIeandpulmonarydiseaseswithoutcorpuhnonale)．ThisgoldstandardwasusedtoevaluatethediagnosticperfbrlnanceofmeasurementofBNPResultsPaIiellfswithLHF(n=341hadBNPlevelsof6l5±392pg／ml，sig

6、ni“cantlyhigherthanthegroupofpatientswitllpulInonarydiseasenotaccolnpalliedbycorpulmonale(n=21)whoseBNPwas60土46pg／lnlandthegroupofpatientswithcorpulmonale(n=24)w110seBNPwas183±145p∥m1．Ataplasmaconcentrationof210p∥ml，BNPwasanaccuraIepredictorofthepresenceofLHF(87．4％)；】Ⅵe

7、asurementslessthant11ishadahighnegativepredictivevalue(90．7％)．Theareaunderthereceiveroperatingcurve，whichplots2坐鏊壁塑耋垄：尘堕丝型堕堕‘壁!堕堕壁鳖型堡堕!!堕璺墨sensitivityversusspecificityforBNPleVelsinthediagnosisofLHF，was0．93(0．88．0．99，p<0．001)．Inmullivariateanalysis，BNPmeasurementsaddeds

8、igni“cant，i11dependentexplanatorypowertoroutinetestsinmodelspredictingwhichpatientshadLHF．ConclusionBNPbloodco