COPD患者血浆氨基酸末端脑钠素前体在运动中的变化  

N-terminal Pro-B-type Natriuretic Peptide Kinetics During Dynamic Exercise in Patients with Stable COPD

作　　者：肖瑶[1] 徐秋芬[2] 王浩彦[2] 樊静[1] 张玲[1] 

机构地区：[1]首都医科大学附属北京安贞医院呼吸科,北京100029 [2]首都医科大学附属北京友谊医院呼吸科,北京100050

出　　处：《中国呼吸与危重监护杂志》2009年第3期216-219,共4页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：北京市科委专项课题(编号:z080507030808025)

摘　　要：目的观察稳定期COPD患者运动前后血浆氨基酸末端脑钠素前体(NT-proBNP)水平的变化,探讨其变化规律及临床意义。方法受试者为稳定期COPD患者19例和健康对照组10例。分别进行递增功率和恒功率心肺运动试验,在递增功率运动前及运动高峰时抽取桡动脉血进行血气分析,在恒功率运动前及运动终止即刻抽取肘静脉血测定血浆中NT-proBNP的浓度。结果稳定期COPD患者在运动高峰时的摄氧量、心率、PaO2及恒功率运动时间均明显低于对照组;稳定期COPD患者和对照组运动前后血浆NT-proBNP水平差异均无统计学意义[(4803.86±1027.07)ng/L和(4572.39±1243.33)ng/L,P=0.542;(4303.18±771.74)ng/L和(4475.71±1025.50)ng/L,P=0.676];所有受试者血浆NT-proBNP水平与各运动指标均无显著相关性。结论运动对稳定期COPD患者血浆NT-proBNP水平无明显影响,心功能障碍不是其运动受限的主要原因。Objective To investigate the change of N-terminal pro-B-type natriuretic peptide （NT-proBNP） levels in plasma of patients with stable chronic obstructive pulmonary disease （ COPD ） at exertion. Methods Pulmonary function testing,increamental and constant cycle ergometer exercise testing were performed in 19 patients with stable COPD and 10 healthy subjects. Arterial blood gas analysis Were measured at rest and maximal exertion in incremental testing. Venous blood samples were drawn both at rest and maximal exercise in constant-load exercise testing and NT-proBNP levels were measured. Results NT-proBNP levels did not change significantly during exercise in the patients with stable COPD [（4803.86±1027.07） ng/L vs （4572.39 ± 1243.33） ng/L, P = 0.542] and the control group [ （4303.18 ±771.74） ng/L vs （4475.71± 1025.50） ng/L, P = 0. 676 ]. NT-proBNP levels were not correlated with parameters of cardiopulmonary exercise testing. Conclusion The factors other than cardiac function may contribute to the exercise intolerance in stable COPD patients without heart failure.

关 键 词：慢性阻塞性肺疾病 氨基酸末端脑钠素前体 运动耐力 心肺运动试验 

分 类 号：R563.9[医药卫生—呼吸系统]