慢性阻塞性肺疾病急性加重期患者检测血浆NT-proBNP和cTnT的临床意义  

Clinical significance of NT-proBNP and cTnT detection in patients with actute exacerbations of chronic obstructive pulmonary disease

作　　者：张阳阳 张一清 王彤 ZHANG Yangyang ZHANG Yiqing WANG Tong(Department of General Internal Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, CHINA)

机构地区：[1]南京医科大学第一附属医院综合内科,江苏省210029 [2]南京医科大学第一附属医院康复医学科,江苏省210029

出　　处：《江苏医药》2016年第20期2227-2229,共3页Jiangsu Medical Journal

摘　　要：目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者检测血浆氨基末端脑钠肽前体(NT-proBNP)和心肌钙蛋白(cTnT)等相关指标的临床意义。方法检测AECOPD(A组,30例)、AECOPD合并轻度肺动脉高压(PH)(B组,20例)及AECOPD合并中重度PH(C组,20例)患者NT-proBNP和cTnT等相关指标,分析肺动脉收缩压(PASP)、右心房内径(RAD)、右心室舒张末内径(RVEDD)及LVEF等心脏彩超参数。结果 B、C组NT-proBNP、cTnT水平及PASP高于A组,RAD和RVEDD大于A组,C组NT-proBNP、cTnT水平及PASP高于B组,RAD和RVEDD大于B组(P<0.01或P<0.05)。B、C组PASP与NT-proBNP、PaCO_2、RAD及RVEDD呈正相关(P<0.05),与PaO_2呈负相关(P<0.05)。A组PASP与NT-proBNP和PaCO2呈正相关(P<0.05),与PaO_2呈负相关(P<0.05),而与RAD和RVEDD无明显相关性(P>0.05)。结论 NT-proBNP和cTnT等相关指标可用于评估AECOPD患者的预后。Objective To explore the clinical significance of N‐terminal pro‐brain natriuretic peptide（NT‐proBNP） and cardiac troponin T（cTnT） detection in patients with actute exacerbation of chronic obstructive pulmonary disease（AECOPD） .Methods Plasma levels of NT‐proBNP and cTnT and other relevant indicators were detected in the patients with AECOPD （group A ,30 cases ） , AECOPD with mild pulmonary hypertension（PH）（group B ,20 cases） and AECOPD with moderate and severe PH（group C ,20 cases） .The heart Doppler ultrasound parameters of pulmonary arterial systolic pressure （PASP ） ,right atrium diameter （RAD ） ,right ventricular end‐diastolic diameter （RVEDD） and LVEF were compared among three groups .Results Plasma levels of NT‐proBNP , cTnT and PASP were higher ,RAD and RVEDD were larger ,in groups of B and C than those in group A ,which were even more in group C than those in group B （P〈0 .01 or P〈0 .05） .The PASP in groups of B and C was positively correlated to NT‐proBNP ,PaCO2 ,RAD and RVEDD （P〈0 .05） , but negatively correlated to PaO2 （ P〈0 .05 ） .The PASP in group A was positively correlated to NT‐proBNP and PaCO2 ,but negatively correlated to PaO2 （P〈0 .05） ,which was not closely related to RAD and RVEDD（P〈0 .05） .Conclusion Plasma levels of NT‐proBNP and cTnT and other relevant indicators mentioned above can be used to evaluate the prognosis of the patients with AECOPD .

关 键 词：慢性阻塞性肺疾病 肺动脉高压 氨基末端脑钠肽前体 心肌钙蛋白 

分 类 号：R562[医药卫生—呼吸系统]