二维超声心动图与BNP、6MWT、mMRC用于评估AECOPD患者右心功能不全的相关性  

Two-dimensional echocardiography and BNP,6MWT and mMRC in evaluating right ventricular dysfunction in patients with AECOPD

作　　者：吴长东[1] 侯铭[1] 杨嵘[1] 张静[1] 范蕾[1] 梁玥[1] 王萍[1] 贺艳[1] 薛克栋[1] WU Chang-dong;HOU Ming;YANG Rong;ZHANG Jing;FAN Lei;LIANG Yue;WANG Ping;HE Yan;XUE Ke-dong(Emergency Centre,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院急救中心

出　　处：《中国临床研究》2020年第1期27-30,共4页Chinese Journal of Clinical Research

基　　金：新疆维吾尔自治区自然科学基金资助项目(2016D01C113);新疆维吾尔自治区人民医院院内科研项目(20150214)~~

摘　　要：目的探讨二维超声心动图(2D-UCG)与B型利钠肽(BNP)、6分钟步行试验(6MWT)、呼吸困难量表(m MRC)用于评估慢性阻塞性肺疾病急性加重(AECOPD)患者右心功能不全的相关性。方法选取2016年5月至2018年5月急诊科收治临床确诊AECOPD患者249例作为研究对象,分别收集一般资料及进行BNP、6MWT、m MRC、2D-UCG等测定,采用诊断符合率和Pearson相关法分析2D-UCG检测与BNP、6MWT、m MRC用于评估AECOPD患者右心功能不全的诊断效能和相互关系。结果以2D-UCG四项试验指标结果任一项阳性判断入组患者右心功能不全风险,则阳性94例(37. 8%),阴性正常155例(62. 2%)。在AECOPD患者右心功能不全的诊断上,2D-UCG与BNP、6MWT、m MRC各项单独判定的符合率分别为67. 87%、42. 57%和54. 22%,2D-UCG与BNP、6MWT、m MRC分别均呈正相关(r=0. 534、0. 605、0. 571,P均<0. 01)。结论 AECOPD患者右心功能不全发生率较高,2D-UCG与BNP、6WMT、m MRC评估AECOPD患者右心功能不全风险具有相关性,提示2D-UCG能够较好评估COPD患者右心功能,与BNP、6WMT、m MRC等指标可在AECOPD右心功能不全发生风险的评估上互为补充。Objective To explore the correlation between two-dimensional echocardiography( 2D-UCG) and B-type brain natriuretic peptide( BNP),6-minute walking test( 6 MWT),dyspnea scale [modified Medical Research Council( mMRC) ]in evaluating right ventricular dysfunction in patients with acute exacerbation of chronic obstructive pulmonary disease( AECOPD). Methods A total of 249 patients with clinically confirmed AECOPD treated in Emergency Department from May 2016 to May 2018 were selected. General data were collected,and BNP,6 MWT,mMRC and 2D-UCG were measured for all patients. The diagnostic accuracy and Pearson correlation analysis were used to evaluate the diagnostic efficacy The diagnostic coincidence rate and Pearson correlation method were used to analyze the diagnostic efficacy and correlation of 2D-UCG with BNP,6MWT,and MMRC for the evaluation of right ventricular dysfunction in patients with AECPD. Results The risk of right ventricular insufficiency in 249 patients was judged by any one of the four test results of 2D-UCG,94( 37. 8%) were positive,and 155( 62. 2%) were negative. Compared with BNP,6 MWT and MMRC in the diagnosis of right ventricular insufficiency in AECOPD patients,the coincidence rates of 2D-UCG were 67. 87%,42. 57% and 54. 22%respectively,and there was a positive correlation between two-dimensional echocardiography and BNP,6 MWT and mMRC( r = 0. 534,0. 605,0. 571,all P < 0. 01). Conclusions The incidence of right ventricular insufficiency in AECOPD patients is higher. 2D-UCG is significantly correlated with BNP,6 WMT and mMRC in evaluating the risk of right ventricular insufficiency in AECOPD patients. It suggests that 2D-UCG can evaluate the right ventricular function in COPD patients effectively and can complement each other with BNP,6 WMT and mMRC in the risk assessment of right ventricular dysfunction in AECOPD.

关 键 词：慢性阻塞性肺疾病 急性加重期 二维超声心动图 B型利钠肽 6分钟步行试验 改良的英国医学研究委员会呼吸困难量表评分 右心功能 

分 类 号：R541.5[医药卫生—心血管疾病] R563.9[医药卫生—内科学]