间质性肺疾病患者脑钠肽与心肺功能的相关性及预后价值初探  

Preliminary Investigation on Correlation between Brain Natriuretic Peptide and Cardiopulmonary Function,Prognosis of Patients with Interstitial Lung Disease

作　　者：黄志俭[1] 罗琴[1] 孙斐宇 吴爱群[1] 林伟[1] 张江东[1] 

机构地区：[1]福建中医药大学附属厦门市中医院急诊科,福建厦门361009

出　　处：《中国呼吸与危重监护杂志》2014年第5期490-493,共4页Chinese Journal of Respiratory and Critical Care Medicine

摘　　要：目的探讨间质性肺疾病患者血清脑钠肽与心肺功能的相关性及对预后的评估作用。方法回顾性选取2010年2月至2013年4月入住厦门市中医院的间质性肺疾病患者的临床资料。采用Pearson和Spearman统计学方法分析患者脑钠肽与心脏多普勒、肺功能各项检查指标的相关性,并将患者分为存活组和死亡组、合并肺动脉高压组与未合并肺动脉高压组,对各项临床指标进行预后价值比较。结果共纳入38例间质性肺疾病患者,其血清B型脑钠肽水平与心脏多普勒右心功能的各项指标、肺动脉收缩压、右心房内径、右心室内径、右心室舒张末期内径均有较好的相关性(P<0.05),而与左心功能的各项指标无显著相关性(P>0.05);与一氧化碳弥散量占预计值百分比(DLCO%pred)有显著相关性(P<0.05)。死亡组和肺动脉高压组患者的脑钠肽水平,以及除右心房内径外其余右心功能指标均显著高于存活组和无肺动脉压组(P<0.05),而前两组DLCO%pred显著低于后两组(P<0.05)。结论间质性肺疾病患者血清脑钠肽水平能较好地反映其右心功能情况,提示间质性肺疾病患者有不同程度的肺血管受累,导致肺血管阻力的增加。而高水平的脑钠肽水平提示患者预后差,病死率高。Objective To investigate the correlation between brain natriuretic peptide（ BNP） and cardiopulmonary function,as well as explore prognostic value of BNP in patients with interstitial lung disease（ ILD）. Methods The clinical data of ILD patients admitted between February 2010 and April 2013 were retrospectively analyzed. The relationship between serum BNP level and cardiopulmonary function was analyzed by Pearson’ s or Spearman’ s rank correlation test. Meanwhile,the patients were divided into a survivor group and a death group,as well as a pulmonary hypertention（ PH） group and a normal group respectively. Clinical data were compared between two groups. Results There were 38 patients included in the study. BNP concentration was correlated with echocardiographic indices of right heart function,including systolic pressure of pulmonary artery,right atrial inlet diameter,right ventricular inlet diameter,and right ventricular end-diastollc diameter（ P 〈 0. 05）,but not correlated with echocardiographic parameters of left heart function（ P 〉 0. 05）. BNP was also correlated with DLCO% pred. BNP and right heart function parameters except right atrial inlet diameter were significantly higher,and DLCO% pred,were significantly lower in the death group and the PH group than those in the survivor group and the normal group（ P 〈0. 05）. Conclusions Serum BNP concentration can reflect right heart function appropriately,suggesting pulmonary vascular impairment in ILD patients contributes to increased pulmonary vascular resistance.Elevated BNP levels are associated with increased mortality and poor prognosis in patients with ILD.

关 键 词：脑钠肽 间质性肺疾病 心肺功能 

分 类 号：R563.9[医药卫生—呼吸系统]