血浆脑钠肽前体与AECOPD患者心功能的相关性研究  

Correlation research between N-terminal pro-brain natriuretic peptide and cardiac function in patients with acute exacerbations of chronic obstructive pulmonary disease

作　　者：杨展正[1] 刘荣[1] 梁子敬[1] 黄伟清[1] 林俊敏[1] 张作鹏[1] 

机构地区：[1]广州医学院第一附属医院急诊科,广东广州510120

出　　处：《海南医学》2013年第14期2095-2097,共3页Hainan Medical Journal

基　　金：国家自然科学基金资助项目(编号:81272062;81071030);广东省科技计划项目(编号:2012B61700046;2012B031800286;2010B031600089);广州医学院博士启动项目(编号:2011C58)

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。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）, leR ventricular end-systolic dimension （LVDs）, left ventricular end-diastolic dimension （LVDd）, right ventricular internal dimension（RV）, intcrventricular scptum 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 an- other with high NT-proBNP （high NT-proBNP group）. Mean artery pressure （MAP）, body mass index （BMI）, creati- nine 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 Be- tween the normal NT-proBNP group and high NT-proBNP group, there were no differences in age, temperature, MAP, hcart rate, breath rate, CCr, creatine kinase （CK-MB）, myoglohin （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, tcmporaturc, 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 lev

关 键 词：氨基末端脑钠肽前体(NT-pro BNP) 慢性阻塞性肺疾病(COPD) 心功能 

分 类 号：R563[医药卫生—呼吸系统]