慢性肺心病急性加重期患者动脉血气、血浆BNP与D-二聚体及血液流变学相关性研究  

Variation of plasma brain natriuretic peptide,arterial blood gas,plasma D-dimer and hemorheology in acute exacerbation of chronic cor pulmonale

作　　者：童亚玲 李乾兵[1] 徐建林[1] 

机构地区：[1]安庆市第一人民医院呼吸内科,安徽安庆246003

出　　处：《皖南医学院学报》2013年第4期278-280,共3页Journal of Wannan Medical College

摘　　要：目的:观察慢性肺心病急性加重期患者与慢阻肺急性加重期患者治疗前后动脉血气分析、血浆脑钠肽(BNP)和血浆D-二聚体、血液流变学的变化,探讨其与肺心病病情严重程度及疗效的相关性。方法:25例慢性肺心病急性加重期患者与26例慢阻肺急性加重期患者给予2周的综合治疗。治疗前后分别测定动脉血气分析、血浆BNP和D-二聚体、血液流变学。结果:慢性肺心病急性加重期患者动脉血气分析、血浆BNP和D-二聚体水平、血液流变学明显存在异常,与病情的严重性具有相关性。治疗2周后,动脉血PaO2、PaCO2、血浆BNP、D-二聚体水平、血液流变学与治疗前比较明显改善,差异有统计学意义(P<0.01);且血浆BNP、D-二聚体水平与动脉血PaO2呈负相关(P<0.05),与动脉血PaCO2、全血粘度、血浆粘度呈正相关(P<0.05)。结论:血浆BNP、D-二聚体可作为判定肺心病急性加重期患者病情严重程度及疗效的指标。Objective： To observe the variation of arterial blood gases,plasma brain natriuretic peptide（BNP） and plasma D-dimer levels and hemorheology in patients with either acute exacerbation of chronic pulmonary heart disease or acute exacerbations of chronic obstructive pulmonary disease（AECOPD） before and after medication for assessing the conditions and therapeutic effects.Methods： Patients with acute exacerbation of chronic cor pulmonale（n = 25） and AECOPD（n = 26） underwent comprehensive therapy for consecutive 2 weeks.The arterial blood gas（PaO2 and PaCO2） analysis was performed,and the concentration of plasma BNP and plasma D-dimer as well as the hemorheological indexes were determined and compared before and after treatment.Results： Significant abnormal levels of arterial PaO2 and PaCO2,plasma BNP and plasma and variation of hemorheological indexes were seen in patients with acute exacerbation of chronic pulmonary heart disease,suggesting that these indicators were associated with severity of the conditions.After two weeks of medication,the previous indicators were improved significantly,which had statistical difference（P ＆lt; 0.01）.Plasma BNP and D-dimer levels were negatively correlated with arterial PaO2（P ＆lt;0.05）,yet positively with arterial PaCO2 and whole blood viscosity,particularly with plasma viscosity（P ＆lt;0.05）.Conclusion： The levels of plasma BNP and D-dimer may serve as indicators for estimation of the severity of acute exacerbation of chronic pulmonary disease and its curative outcomes.

关 键 词：肺心病 脑钠肽 D-二聚体 血气分析 血液流变学 

分 类 号：R541.5[医药卫生—心血管疾病]