N末端B型脑钠肽前体水平监测对肺癌患者围手术期急性心力衰竭的临床意义  

Clinical significance of monitoring N-terminal pro-brain natriuretic peptide level in perioperative acute heart failure in patients with lung cancer

作　　者：雷鑫篪 姚健[2] 张强 邹金龙 张海洋 LEI Xinchi;YAO Jian;ZHANG Qiang;ZOU Jinlong;ZHANG Haiyang(School of Clinical Medicine,Changchun University of Chinese Medicine,Changchun 130012,Jilin,China;Department of Thoracic Surgery,Jilin Province People’s Hospital,Changchun 130012,Jilin,China)

机构地区：[1]长春中医药大学临床医学院,长春130012 [2]吉林省人民医院胸外科,长春130012

出　　处：《癌症进展》2024年第8期846-849,880,共5页Oncology Progress

基　　金：北京医学奖励基金会课题研究项目(YXJL-2020-0785-1169)。

摘　　要：目的探讨N末端B型脑钠肽前体(NT-proBNP)水平监测对肺癌患者围手术期急性心力衰竭(AHF)的临床意义。方法选取40例肺癌手术患者,分别于术前2 h、术中、术后2 h检测血清NT-proBNP水平,分析患者围手术期血清NT-proBNP水平变化情况。结果40例肺癌患者术前2 h、术中和术后2 h血清NT-proBNP水平比较,差异有统计学意义(P﹤0.01),术中、术后2 h,肺癌患者血清NT-proBNP水平高于术前2 h,差异均有统计学意义(P﹤0.05)。术中血清NT-proBNP水平较术前2 h升高的有37例,术后2 h血清NT-proBNP水平高于术前2 h的有38例,且大部分患者术后2 h时血清NT-proBNP水平虽较术中有所降低,但仍高于术前水平。40例肺癌患者,行胸腔镜下肺叶部分切除术27例,胸腔镜下肺叶切除术13例。术中和术后2 h,胸腔镜下肺叶部分切除术患者血清NT-proBNP水平均明显高于本组术前2 h,差异均有统计学意义(P﹤0.01),其中术中血清NT-proBNP水平高于术前2 h的有25例,术后2 h血清NT-proBNP水平高于术前2 h的有26例。术中、术后2 h,胸腔镜下肺叶切除术患者血清NT-proBNP水平均明显高于本组术前2 h,差异均有统计学意义(P﹤0.01),其中术中血清NT-proBNP水平高于术前2 h的有12例,术后2 h血清NT-proBNP水平高于术前2 h的有12例。结论围手术期监测血清NT-proBNP水平对降低肺癌患者AHF发生率、提高手术安全性有重要意义。Objective To investigate the clinical significance of monitoring N-terminal pro-brain natriuretic peptide(NT-proBNP)levels in perioperative acute heart failure(AHF)in patients with lung cancer.Method A total of 40 patients with lung cancer who underwent surgery were selected,and the serum NT-proBNP levels were detected at 2 h before surgery,during surgery,and 2 h after surgery.The changes in serum NT-proBNP levels during the perioperative period were analyzed.Result The serum NT-proBNP levels in 40 patients with lung cancer at 2 h before surgery,during surgery,and 2 h after surgery were compared,the difference was statistically significant(P<0.01).During surgery and 2 h after surgery,the serum NT-proBNP levels in patients with lung cancer were higher than those 2 h before surgery,and the differences were statistically significant(P<0.05).A total of 37 cases had higher serum NT-proBNP levels during surgery compared to 2 h before surgery,and 38 cases had higher serum NT-proBNP levels at 2 h after surgery compared to 2 h before surgery.Although the serum NT-proBNP levels in most patients decreased compared to during surgery,they were still higher than preoperative levels at 2 h before surgery.Among 40 patients with lung cancer,27 cases underwent thoracoscopic partial lobectomy and 13 cases underwent thoracoscopic lobectomy.During surgery and 2 h after surgery,the serum NT-proBNP levels in patients undergoing thoracoscopic partial lobectomy were significantly higher than those in 2 h before surgery,and the differences were statistically significant(P<0.01).Among them,25 cases had higher serum NTproBNP levels during surgery than 2 h before surgery,and 26 cases had higher serum NT-proBNP levels at 2 h after surgery than 2 h before surgery.During surgery and 2 h after surgery,the serum NT-proBNP levels in patients undergoing thoracoscopic lobectomy were significantly higher than 2 h before surgery,the differences were statistically significant(P<0.01).Among them,12 cases had higher serum NT-proBNP levels during surgery

关 键 词：肺癌 N末端B型脑钠肽前体 围手术期 急性心力衰竭 

分 类 号：R734.2[医药卫生—肿瘤]