【摘要】 目的采用血浆氨基末端脑钠肽前体(NT-pro BNP)水平评价慢性阻塞性肺疾病急性加重期(AECOPD)患者心脏功能的相关性研究。方法对广州医学院第一附属医院急诊科收治AECOPD患者71例进行血浆NT-proBNP、血生化、心脏生化及心脏超声(入院48h内)等检测,比较NT-pro BNP水平正常组和升高组一般情况、血生化、心脏生化及心脏超声;分析NT-pro BNP水平与血生化、心脏生化及心脏超声等之间的相关性。结果 NT-pro BNP值正常组和升高组的年龄、体温、平均动脉压(MAP)、心率、呼吸、血肌酐清除率(CCr)、肌酸激酶(CK-MB)、肌红蛋白(Myo),比较差异无统计学意义(P>0.05),体质量指数(BMI)、肌钙蛋白(Tn-I)两组间比较差异有统计学意义(P<0.05或P<0.01)。心脏超声示RA、RV、LA、LVDd、LVDs值两组间比较差异无统计学意义(P>0.05),WBC、IVS、LV、EF、PASP值两组间比较差异有统计学意义(P<0.05)。升高组NT-pro BNP值与年龄、体温、Tn-I、Myo、LVDd、IVS、PASP呈正相关,与BIM、Hct、CCr、LV、EF呈负相关。结论血浆NT-pro BNP值的升高与AECOPD患者的心功能状态存在相关性,NT-pro BNP可用于早期评价AECOPD患者的心脏功能。更多还原

【Abstract】 Objective To evaluate the correlation of the plasma N-terminal pro-brain natriuretic peptide(NT-pro BNP) and the cardiac function in patients with acute exacerbations of chronic obstructive pulmonary disease(AECOPD).Methods In Emergency Room,71 patients with AECOPD were measured for plasma NT-pro BNP,blood biochemistry,cardiac biochemical and Doppler echocardiography,which underwent echocardiography for left atrium internal dimension(LA),right atrium internal dimension(RA),left ventricular end-systolic dimension(LVDs),left ventricular end-diastolic dimension(LVDd),right ventricular internal dimension(RV),interventricular septum thickness(IVS),pulmonary arterial systolic pressure(PASP) and left ventricular ejection fraction(LVEF) in 48 h after admission.All patients were divided into two groups:one with normal NT-proBNP(normal NT-proBNP group) and another with high NT-proBNP(high NT-proBNP group).Mean artery pressure(MAP),body mass index(BMI),creatinine clearance rate(CCr),LA,RA,LVDs,LVDd,IVS,PASP,LVEF were compared according to Plasma NT-proBNP levels.In addition,we examined correlations between plasma NT-proBNP levels and these parameters.Results Between the normal NT-proBNP group and high NT-proBNP group,there were no differences in age,temperature,MAP,heart rate,breath rate,CCr,creatine kinase(CK-MB),myoglobin(Myo),except BMI(P<0.05) and Tn-I(P<0.05).There were no differences in RA,RV,LA,LVDd,LVDs.Patients with high NT-proBNP had thicker IVS(P<0.05),lower LVEF(P<0.05) and higher PASP(P<0.05) than those of the patients with normal NT-proBNP.The high plasma NT-proBNP level were positively correlated with age,temperature,Tn-I,Myo,LVDd,IVS,PASP(r=0.327,0.246,0.565,0.305,0.32,0.327,0.404) and negatively correlated with CCr,LVEF(r=-0.214,-0.245,-0.424).Conclusion There is a correlation between the higher plasma NT-pro BNP level and cardiac function in patients with AECOPD.Plasma NT-proBNP can be a useful prognostic marker to monitor early stage cardiac function in AECOPD patients.更多还原