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目的:比较充血性心力衰竭(congestive heart failure,CHF)及肺源性心脏病(pulmonary heart disease,PHD)患者急性呼吸困难发作时及缓解后1周血浆脑钠尿肽(BNP)水平的变化并分析其临床意义。方法:采用全血化学发光法测定CHF及PHD患者急性呼吸困难发作时及缓解后1周血浆BNP水平。结果:CHF患者呼吸困难发作时血浆BNP水平明显高于病情缓解后1周血浆BNP水平[(1997±865)ng/L vs.(184±114)ng/L,P<0.05],PHD患者呼吸困难发作时血浆BNP水平明显高于病情缓解后1周血浆BNP水平[(679±202)ng/L vs.(145±48)ng/L,P<0.05],呼吸困难发作时CHF组患者血浆BNP水平明显高于PHD组(P<0.05),呼吸困难缓解后1周两组间无显著差异。结论:BNP水平可作为CHF患者病情严重程度及疗效判断的评价指标。也可作为临床协助鉴别CHF呼吸困难与PHD重度肺功能不全呼吸困难的检测指标之一。
Objective: To compare the changes of plasma brain natriuretic peptide (BNP) levels in patients with congestive heart failure (CHF) and pulmonary heart disease (PHD) at the onset of acute dyspnea and at 1 week after remission Analyze its clinical significance. Methods: Plasma BNP levels were measured at the onset of acute dyspnea and at 1 week after remission in CHF and PHD patients by whole blood chemiluminescence. Results: Plasma BNP levels in patients with dyspnea at CHF were significantly higher than those at 1 week after CHF ([1997 ± 865] ng / L vs (184 ± 114) ng / L, P <0.05] Plasma BNP levels in patients with dyspnea were significantly higher than those at 1 week after remission (679 ± 202 ng / L vs. 145 ± 48 ng / L, P <0.05) BNP level was significantly higher than PHD group (P <0.05), 1 week after relief of dyspnea no significant difference between the two groups. Conclusion: The level of BNP can be used as an evaluation indicator of the severity of CHF and judgment of curative effect. It can also be used as a clinical marker to identify dyspnea of CHF and dyspnea of severe pulmonary insufficiency in PHD.