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目的:探讨慢性肺源性心脏病失代偿期患者血浆N-端脑利钠肽前体(NT-proBNP)的变化及其临床意义。方法:将2012年1月至2015年1月广东省江门市新会区第二人民医院收治的69例慢性肺源性心脏病失代偿期患者与52例慢性阻塞性肺疾病(COPD)患者作为研究对象,采用快速电化学发光法分别测定两组患者血浆NT-proBNP浓度,并行血气分析和心脏彩色超声检查。待治疗缓解后复查血浆NTproBNP浓度。结果:慢性肺源性心脏病失代偿期患者急性加重期NT-proBNP浓度显著高于COPD急性加重期患者(P<0.05),各组急性加重期NT-proBNP浓度显著高于缓解期(P<0.05)。慢性肺源性心脏病失代偿期患者急性加重期血浆NT-proBNP水平与肺动脉压、右心室舒张期内径、右心室流出道宽度、总血红蛋白呈正相关(P<0.05);COPD患者急性加重期NT-proBNP水平与PAP呈正相关(P<0.05)。结论:血浆NT-proBNP参与了肺源性心脏病的病理生理过程,测定NT-proBNP浓度有助于判断肺源性心脏病病情严重程度。
Objective: To investigate the changes of plasma N-terminal pro brain natriuretic peptide (NT-proBNP) in patients with decompensated chronic cor pulmonale and its clinical significance. Methods: From January 2012 to January 2015, 69 patients with decompensated chronic cor pulmonale and 52 patients with chronic obstructive pulmonary disease (COPD) admitted to the Second People’s Hospital of Xinhui District, Jiangmen City, Guangdong Province, As the research object, rapid electrochemiluminescence was used to measure plasma NT-proBNP concentration, blood gas analysis and cardiac color echocardiography in two groups respectively. Plasma NTproBNP concentrations were examined after treatment was relieved. Results: NT-proBNP concentration in acute decompensation patients with chronic cor pulmonale was significantly higher than that in acute exacerbation patients with COPD (P <0.05), and the concentration of NT-proBNP in acute exacerbation of each group was significantly higher than that in remission (P <0.05). The level of NT-proBNP in acute exacerbation of patients with chronic cor pulmonale was positively correlated with pulmonary arterial pressure, diastolic diameter of right ventricle, width of right ventricular outflow tract, and total hemoglobin (P <0.05). In acute exacerbation of COPD The level of NT-proBNP was positively correlated with PAP (P <0.05). Conclusion: Plasma NT-proBNP is involved in the pathophysiological process of pulmonary heart disease. The determination of NT-proBNP concentration may be helpful in judging the severity of pulmonary heart disease.