CTEPH患者血浆NT-proBNP与右心漂浮导管测定血流动力学的关系  

Relationship between plasma NT-pro BNP and right cardiac catheterization in patients with CTEPH

作　　者：马宣[1] 丁学梅[1] 纳建荣[1] 杨小萍[1] 周玮[1] 

机构地区：[1]宁夏医科大学总医院心脑血管病医院呼吸与危重症医学科,宁夏银川750002

出　　处：《临床肺科杂志》2017年第5期897-900,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨慢性血栓栓塞性肺动脉高压(CTEPH)患者血浆N-端脑钠肽前体(NT-pro BNP)水平变化与肺血管阻力、右心功能的关系。方法选取2013年1月-2015年12月在本院诊治的72例CTEPH患者进行研究,其中轻度肺动脉高压9例、中度28例、重度35例,所有患者均进行右心漂浮导管及血浆NTpro BNP检测,比较不同肺动脉高压患者的各项指标并进行多元回归分析。结果不同肺动脉压分级CTEPH患者的肺动脉收缩压、肺动脉舒张压、肺动脉压、肺血管阻力、肺毛细血管楔压,组间比较的关系呈轻度患者<中度患者<重度患者,组间差异均具有统计学意义(P<0.05);不同肺动脉压分级患者的右心输出量、右心做功量组间比较的关系呈轻度患者>中度患者>重度患者,组间差异均具有统计学意义(P<0.05);不同肺动脉压CTEPH分级患者的血浆NT-pro BNP组间比较的关系呈轻度患者<中度患者<重度患者,组间差异均具有统计学意义(P<0.05);CTEPH患者的肺血管阻力与血浆NT-pro BNP水平呈显著的正相关关系(P<0.05);CTEPH患者的右心输出量、右心做功量与血浆NT-pro BNP水平呈显著的负相关关系(P<0.05)。结论可以通过检测CTEPH患者NT-pro BNP水平对患者的肺动脉阻力及右心功能进行评估。Objective To investigate the relationship of plasma N-terminal pro brain natriuretic peptide （NT proBNP） with pulmonary vascular resistance and right heart function in patients with chronic thromboembolic pulmo- nary hypertension （CTEPH）. Methods 72 cases of CTEPH patients treated in our hospital were selected from Jan- uary 2013 to December 2015, including 9 eases of mild pulmonary hypertension, 28 cases of moderate and 35 severe cases. All patients underwent right heart catheterization and floating plasma NT -proBNP test, and the indicators were compared by multiple regression analysis. Results The value of pulmonary artery systolic pressure, diastolic pulmo- nary artery pressure, pulmonary artery pressure, pulmonary vascular resistance, and pulmonary eapillary wedge pres- sure was the lowest in the mild group, followed by the moderate group and the severe group （ P 〈 0. 05 ）. The value of right cardiac output and right ventricular work load were the highest in the mild group, followed by the moderate group and the severe group （ P 〈 0. 05 ）. The level of plasma NT-proBNP was the lowest in the mild group, followed by the moderate group and the severe group （ P 〈 0. 05 ）. Plasma NT-proBNP level was positively correlated with lung vascu- lar resistance （P 〈 0. 05 ）, and negatively correlated with right cardiac output and right heart work load （ P 〈 0. 05 ）. Conclusion The detection of NT-proBNP level in patients with CTEPH can evaluate their pulmonary arterial resist- ance and right ventricular function.

关 键 词：慢性血栓栓塞性肺动脉高压 N-端脑钠肽前体 肺血管阻力 右心功能 

分 类 号：R544.1[医药卫生—心血管疾病]