BNP在急诊CAP和COPD加重病情评估中的意义  

Utility of B-type natriuretic peptide in evaluating disease severity of community-acquired pneumonia and chronic obstructive pulmonary disease exacerbation patients presenting to the emergency department

作　　者：李京[1] 赵丽[1] 刘士立 LI Jing;ZHAO Li;LIU Shi-li.The Emergency(Department of the Fu Xing Hospital,Capital Medical University,Beijing,100038,China.)

机构地区：[1]首都医科大学附属复兴医院急诊科,北京100038

出　　处：《中国急救复苏与灾害医学杂志》2018年第8期724-726,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的B型钠尿肽（B type natriureti cpeptide，BNP）作为预后指标在急诊科收治的社区获得性肺炎（community acquired pneumonia，CAP）和慢性阻塞性肺病（chronic obstructive pulmonary disease，COPD）加重患者中的实用性。方法选取2015年5月一2016年4月首都医科大学附属复兴医院收治的56例因呼吸困难就诊患者分为伴有SIRS的CAP组、COPD加重组和急性支气管炎组。测定患者的BNP和生命体征、炎症指标、血气分析、生化指标、肝肾功能等，观察3组患者BNP水平及与炎症指标之间以及住院时间之间相关性。结果与急性支气管炎患者相比，CAP患者的平均BNP值显著升高（P=0．003），且BNP值与住院时间之间有显著的正相关性（r=0．767，P〈0．01）。多元线性回归分析显示，白细胞计数是住院时间的唯一独立预测因子（r=0．67，P=0．037）。结论与急性支气管炎患者相比，伴有SIRS的CAP患者的平均BNP水平明显增长，BNP可以为急诊收治的CAP患者提供及时、高效、准确病情严重度判断。Objective In this study ,we want to investigate the utilitarian of BNP（B type natriuretic peptide） as a prognosis factor among CAP（Community acquired pneumonia） and COPD（chronic obstructive pulmonary disease） patients admitted by Emergency department. Methods We enrolled 56 patients with dyspnea admitted by the emergency room of FuXing Hospital attached by Capital Medical University from April to May 2015. The results of BNP, Hs-CRP, ESR, With Blood Cell counting, heart rate, MAP, body temperature, ect were collected at the time of admission. According to the history of the patient, we divided them into three groups.（CAP patients with SIRS,patients diagnosed with AECOPD and with acute bronchitis）. The correlation of serum BNP level and inflammatory biomarkers and length of hospital stay was evaluated. Results Compared with patients with acute bronchitis, BNP serum level of CAP patients significantly Increased.（ 127.2＋80.6 vs 45.9＋38.3 pg/ml; P〈 0.05）. Meanwhile, it also correlated with length of hospital stay positively.（ r=0.404; p=O.05） The mode of multiple regression analysis indicated that With Blood Cell counting was an independent prognostic factor of the length of hospital staying.（ r=0.67, P=0.037）. Conclusions Compared with acute bronchitis patients, average level of serum BNP among patients diagnosed CAP wih SIRS was significantly increased. BNP could be an effective factor to detect and appraise the Severity of physical condition of patients with respiratory symptoms in emergency room.

关 键 词：社区获得性肺炎 B型钠尿肽 脓毒症 慢性阻塞性肺病 

分 类 号：R459.7[医药卫生—急诊医学]