关键词: B型利钠肽, 充血性心力衰竭, 超声心动图, 诊断

Abstract:

Objective To investigate the clinical significance of the B-type natriuretic peptide(BNP) in the differential diagnosis of acute dyspnea,its role and contribution to staging of the congestive heart failure(CHF),and its advantages for the CHF diagnosis compared with the ultrasonic cardiography(UCG).Methods The plasma BNP levels in 86 patients with dyspnea were determined and the left ventricular ejection fraction(LVEF) measured by UCG,taking BNP>100 ng/L and LVEF<50% as the diagnostic criteria of CHF.The cardiac functions of patients clinically diagnosed as CHF were divided into four stages based on the New York Heart Association(NYHA) criteria.Comparison was performed between the clinical diagnoses and BNP levels.Results The BNP levels were significantly different between the non-CHF group and CHF group,and among CHF groups at different stages.In each of which the P value was less than 0.001.BNP had high sensitivity(98.5%), positive predictive value(94.4%),and negative predictive value(93.3%).The specificity of BNP(77.8%) was slightly lower than that of UCG(94.4%);the positive predictive values were almost equal,being 94.4% and 97.8% respectively.BNP,however,had absolute advantages in terms of sensitivity and negative predictive value as compared with those of UCG which were 64.7% and 41.5%,respectively.Conclusion BNP is a rapid,accurate,and quantitative index in the diagnosis of CHF and in differential diagnosis as compared with UCG,especially in terms of the sensitivity and the negative predictive value.

Key words: B-type natriuretic peptide, congestive heart failure, ultrasonic cardiogram, diagnose