摘要
目的分析桥接整合因子1(BIN1)在心源性哮喘与肺源性哮喘鉴别诊断中的意义。方法选取2017年5月—2018年12月北京安贞医院急诊科诊治以呼吸困难为主要症状的患者114例作为研究对象,完善相关检查后分为心源性哮喘组(n=66)和肺源性哮喘组(n=48),同期于体检中心随机选择健康者50例为健康对照组(n=50),测定血浆中BIN1、B型利钠肽(BNP)浓度,比较各组2项指标浓度的差异及BIN1与BNP对心源性哮喘的诊断价值。结果与肺源性哮喘组比较,心源性哮喘组BIN1降低(P<0.05),BNP浓度则明显升高(P<0.05),根据NYHA心功能分级,心功能越差,BIN1水平下降越明显(F=4.312,P=0.021),BNP水平则升高越明显(F=10.876,P=0.012)。多元Logistic回归分析发现,BIN1是发生心源性哮喘的保护因素(OR=0.467,P=0.033),而BNP是发生心源性哮喘的危险因素(OR=1.079,P=0.018)。ROC曲线分析显示,BIN1预测心源性哮喘的曲线下面积(AUC)为0.804(95%CI 0.723~0.852),敏感度和特异度分别为85.1%和91.7%,Youden指数0.768。BNP预测心源性哮喘的AUC为0.852(95%CI 0.782~0.943),敏感度和特异度分别为92.4%和79.2%,Youden指数0.716。BIN1联合BNP诊断心源性哮喘的AUC为0.891(95%CI 0.856~0.934),敏感度和特异度分别为86.3%和92.6%,Youden指数0.790。结论血浆BIN1检测对鉴别心源性哮喘与肺源性哮喘具有一定的意义,二者联合检测对于心源性哮喘具有更高的诊断价值。
Objective To analyze the significance of bridge integration factor 1(BIN1)in the differential diagnosis of cardiogenic asthma and pulmonary asthma.Methods From May 2017 to December 2018,114 patients with dyspnea as the main symptom diagnosed and treated in the Emergency Department of Beijing Anzhen Hospital were selected as the study object.After the completion of relevant examination,they were divided into cardiogenic asthma group(n=66)At the same time,50 healthy people were randomly selected as the control group(n=50)in the physical examination center.The concentrations of BIN1 and B-type natriuretic peptide(BNP)in the plasma were measured.The differences of 2 indexes in each group and the diagnostic value of BIN1 and BNP in cardiogenic asthma were compared.Results Compared with the pulmonary asthma group,BIN1 decreased(P<0.05)and BNP increased significantly(P<0.05)in the cardiac asthma group.According to the NYHA cardiac function classification,the worse the cardiac function,the more obvious the decrease of BIN1 level(F=4.312,P=0.021),and the higher the BNP level(F=10.876,P=0.012).Multiple logistic regression analysis showed that BIN1 was the protective factor of cardiogenic asthma(OR=0.467,P=0.033),while BNP was the risk factor of cardiogenic asthma(OR=1.079,P=0.018).ROC curve analysis showed that the AUC of BIN1 was 0.804(95%CI 0.723~0.852),the sensitivity and specificity were 85.1%and 91.7%,respectively,and the Youden index was 0.768.The AUC of BNP was 0.852(95%CI 0.782~0.943),the sensitivity and specificity were 92.4%and 79.2%,respectively,and the Youden index was 0.716.The AUC of BIN1 combined with BNP was 0.891(95%CI 0.856~0.934),the sensitivity and specificity were 86.3%and 92.6%respectively,and the Youden index was 0.790.Conclusion The detection of BIN1 in plasma has a certain significance in distinguishing between cardiogenic asthma and pulmonary asthma.The combined detection of BIN1 in plasma has a higher diagnostic value for cardiogenic asthma.
作者
王成钢
蒋志丽
李艳芳
聂绍平
阙斌
Wang Chenggang;Jiang Zhili;Li Yanfang;Nie Shaoping;Que Bin(Department of Emergency, Beijing Anzhen Hospital, Capital Medical University,Beijing 100029,China)
出处
《疑难病杂志》
CAS
2020年第5期467-471,共5页
Chinese Journal of Difficult and Complicated Cases
基金
北京市医管局重点医学发展计划(ZYLX201710)。
关键词
桥接整合因子1
心力衰竭
B型利钠肽
心源性哮喘
肺源性哮喘
鉴别诊断
Bridging integration factor 1
Heart failure
Brain natriuretic peptide
Cardiac asthma
Pulmonary asthma
Differential diagnosis
