氨基末端脑钠肽前体和D-二聚体在慢性阻塞性肺疾病患者中检测的临床意义  

Clinical significance of N-terminal pro-brain natriuretic peptide and D-dimer in patients with chronic obstructive pulmonary disease

作　　者：郑国峰[1] 张军[1] 

机构地区：[1]中国医科大学附属第四医院呼吸内科,沈阳110005

出　　处：《中国医师进修杂志》2015年第4期273-275,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨血清氨基末端脑钠肽前体（NT-proBNP）和血浆D-二聚体（D-D）在慢性阻塞性肺疾病急性加重期（AECOPD）和稳定期患者中的水平变化,并分析其临床意义.方法 对76例AECOPD患者（AECOPD组）及68例稳定期COPD患者（稳定期COPD组）的临床资料进行回顾性分析.所有患者均进行血清NT-proBNP和血浆D-D检测及动脉血气分析.结果 AECOPD组血清NT-pro BNP及血浆D-D水平显著高于稳定期COPD组[（918 ±271） ng/L比（264±32） ng/L,（0.269±0.048） mg/L比（0.223±0.042） mg/L],差异有统计学意义（P＜0.01）.血清NT-proBNP和血浆D-D水平与动脉血氧分压呈负相关（r=-0.181,P=0.030;r=-0.166,P=0.047）,与动脉血二氧化碳分压呈正相关（r=0.763,P＜0.01;r=0.424,P＜0.01）.结论 联合检测血清NT-proBNP和血浆D-D水平变化对评估COPD的病情变化有重要的临床意义,可以提示COPD急性加重。Objective To explore the clinical significance of serum N-terminal pro-brain natriuretic peptide （NT-proBNP） and plasma D-dimer （D-D） in patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） and stable chronic obstructive pulmonary disease （COPD）.Methods The clinical data of 76 patients with AECOPD （AECOPD group） and 68 patients with stable COPD （stable COPD group） were analyzed retrospectively.Serum NT-proBNP,plasma D-D levels and arterial blood gas analysis were measured and compared.Results The levels of serum NT-proBNP and plasma D-D in AECOPD group were （918 ± 271） ng/L and （0.269 ±0.048） mg/L,in stable COPD group were （264 ± 32） ng/L and （0.223 ± 0.042） mg/L.The levels of serum NT-proBNP and plasma D-D in AECOPD group were significantly higher than those in stable COPD group （P 〈 0.01）.The levels of serum NT-proBNP and plasma D-D were negatively correlated with arterial blood oxygen partial pressure （r =-0.181,P =0.030;r =-0.166,P =0.047）,and were positively correlated with arterial blood carbon dioxide partial pressure （r =0.763,P 〈 0.01;r =0.424,P 〈 0.01）.Conclusion Combined detection of serum NT-proBNP and plasma D-D has important clinical significance in evaluating severity of COPD,and may indicate AECOPD.

关 键 词：肺疾病 慢性阻塞性 氨基末端脑钠肽前体 D-二聚体 

分 类 号：R563.9[医药卫生—呼吸系统]