| Objective To study the correlation between plasma NT-pro BNP and cardiac and pulmonary dyspnea,and to explore the clinical application value of NT-pro BNP to distinguish cardiac and pulmonary dyspnea.Methods One hundred and seventy-nine patients were selected from the First Affiliated Hospital of Fujian Medical university from July 2018 to Dec.2018.According to the causes of dyspnea and divided into two groups: cardiac dyspnea group(n=91)and pulmonary dyspnea group(n=88).All subjects of clinical data were Recoreded,including age,body mass index(BMI),respiratory rate,temperature,Percutaneous oxygen saturation,systolic blood pressure,diastolic blood pressure,smoking,diabetes,chronic kidney disease,medication history,and white blood cells,C-reactive protein,serum creatinine,glomerular filtration rate,uric acid,low density lipoprotein cholesterol,NT-pro BNP,left ventricular ejection fraction,and compared the correlation of these indicators between two groups.Results(1)Compared with the pulmonary dyspnea group,patients in the cardiac dyspnea group were more likely to be associated with hypertension,diabetes,coronary heart disease,atrial fibrillation,renal dysfunction,and had lower LVEF,higher E/e,,LVDd,and more frequent cardiovascular medication.Patients in the cardiac dyspnea group were more likely to have lower limb edema and orthopnea,while patients in the pulmonary dyspnea group were more likely to have lung rale,faster R and lower Sp O2 and BMI.In terms of blood analysis,Scr,GFR,CRP,UA and LDL-C of the two groups showed significant difference.Scr and UA of the cardiogenic dyspnea group were higher and GFR,CRP and LDL-C were lower than that of the pulmonary dyspnea group.(2)Plasma NT-pro BNP concentrations(M=3550.00pg/ml,IQR=1770.00-7470.00pg/ml)in the cardiac dyspnea group were significantly higher than that in the pulmonary dyspnea group(147.10pg/ml,IQR=70-461.85pg/ml)(P<0.001).Plasma NT-pro BNP concentrations in the cardiac dyspnea group was positively correlated with degree of dyspnea in HF(r=0.515,P=0.004).the higher the cardiac function grade was,the higher the NT-pro BNP concentrations was.(3)Plasma NT-pro BNP concentrations was no significantly correlated with BMI,age,LDL-C,E/e,and positively correlated with LVDd、Scr、UA and negatively correlated with LVEF、GFR in the cardiac dysspnea group.(4)Plasma NT-pro BNP concentrations was negatively correlated with GFR,UA and no significantly correlated with LVEF,LDL-C,E/e,in the pulmonary dyspnea group.(5)There were statistics significance in difference of plasma NT-pro BNP concentrations among the HFr EF group,HFmr EF group,HFp EF groups(P= 0.008).In reagard to plasma NT-pro BNP concentrations,there was significant difference between HFr EF group and HFp EF group,and no statistics significance between HFr EF group and HFmr EF group(P= 0.220)or HFmr EF group and HFp EF group(P=0.730).There was no significant correlation between NT-pro BNP and LVEF in HFr EF group(r=-0.202,P=0.267)and in HFp EF group(r=-0.095,P=0.531).(6)In the pulmonary dyspnea group,with respiratory failure group or with pulmonary hypertension,NT-pro BNP concentrations is higher(P=0.036).Plasma NT-pro BNP concentrations was no statistics significance among different etiologies of cardiac dysspnea(P=0.278).(7)After Using binary Logistic regression model,plasma NT-pro BNP was associated with an increased risk of cardiogenic dyspnea(OR=345.85,95%Cl:9.97-11993.56).(8)ROC curve analysis indicated that NT-pro BNP had a high sensitivity and specificity for the identification of pulmonary and cardiac dyspena difficulties(AUC=0.929,95%Cl : 0.88-0.92,P<0.001),and the optimal cut-off point was 989.8pg/m L,with a sensitivity of 89.01% and a specificity of 87.50%Conclusion Plasma NT-pro BNP concentrations was significantly higher in patients with cardiac dyspnea than that in patients with pulmonary dyspnea.NT-pro BNP concentrations has reference value in the identification of different diseases with pulmonary dyspnea. |
PDF Full Text Request