血浆NT-proBNP检测在稳定期无肺动脉高压COPD患者中的意义  

Significnance of detecting plasma level of NT-proBNP in COPD patients in stable stage without pulmonary hypertension

作　　者：刘凌云[1] 曾勉[2] 左万里[1] 康丽玫[3] 

机构地区：[1]江门市中心医院呼吸内科, 529000 [2]中山大学第一附属医院MICU, 广州510000 [3]江门市中心医院爱婴区, 529000

出　　处：《国际医药卫生导报》2015年第9期1217-1220,共4页International Medicine and Health Guidance News

摘　　要：目的 探讨血浆NT-proBNP检测在彩超检查无肺动脉高压或肺心病稳定期慢性阻塞性肺疾病（COPD）中的意义.方法 选60例COPD患者和30例健康对照者,并进行血浆BNP检测、超声心动图检查、动脉血气分析和肺功能测定.对血浆BNP水平高的COPD患者和血浆BNP水平低的COPD患者进行2年的急性加重期情况的随访比较.结果 稳定期COPD患者血浆NT-ProBNP（680.6±54.78） pg/ml显著高于健康对照组[（120.4± 15.65） pg/ml] （P＜0.05）.血浆NT-ProBNP水平和射血分数之间呈显著负相关（r=-0.56,P＜0.05）和肺动脉收缩压呈显著正相关（r=0.68,P＜0.05）.在2年的急性加重情况随访期间,以NT-proBNP≥500 pg/n1为截点值,血浆NT-ProBNP水平高的COPD患者从开始随访到初次的COPD急性加重的时间[（6.25±1.23）月]较血浆NT-ProBNP水平低的患者加重的时间[（10.13±2.08）月]显著缩短（P＜0.05）,且急性加重的次数（3.35±0.25）显著增加（P＜0.05）.结论 血浆BNP是一种非侵入性生物标志物,可以作为COPD潜在肺动脉高压及左室功能障碍的一个筛选参数,并可作为稳定期患者急性加重的预测因素.Objective To investigate the significance of detecting the plasma level of brain natriuretic peptide （BNP） in color ultrasound checking COPD patients in stable stage without pulmonary hypertension or corpulmonale.Methods 60 patients with COPD and 30 healthy subjects were chosen.Their plasma level of BNP,echocardiography,arterial blood gas analysis,and spirometry were detected.The status of acute exacerbation of the COPD patients with high or low plasma BNP levels were compared and followed up for 2 years.Results The plasma level of NT-ProBNP of the COPD patients in stable stage was （680.6±54.78） pg/ml,which was significantly higher than that of the normal subjects （120.4±15.65） pg/ml （P〈0.05）.Plasma level of BNP negatively correlated with ejection fraction （r=-0.56,P〈0.05） and positively correlated with pulmonary artery systolic pressure （r=0.68,P〈0.05）.During the 2 years＆#39; followup of acute exacerbation status,with plasma level of NT-ProBNP 〉500 pg/ml as the cut-off,the time from the beginning of the follow-up to the first acute exacerbation of COPD was shorter and the times of acute exacerbation was more in the patients with high than low plasma level of NT-ProBNP [（6.25±1.23） months vs.（10.13±2.08） months and （3.35±0.25） vs.（1.12±0.18）,P〈0.05].Conclusions Plasma BNP is a noninvasive biomarker that can be used as a screening parameter for latent PH and left ventricular dysfunction and also as a predictor of exacerbation in stable COPD.

关 键 词：慢性阻塞性肺疾病 NT—proBNP 肺动脉高压 肺心病 

分 类 号：R563[医药卫生—呼吸系统]