B型脑钠肽和D二聚体在慢性肺源性心脏病患者中检测临床意义.doc

B型脑钠肽和D二聚体在慢性肺源性心脏病患者中检测临床意义 　　【摘要】 目的：探讨B型脑钠肽（BNP）和D-二聚体（D-dimer）在慢性肺源性心脏病（CPHD）患者中的水平变化，分析其临床意义。方法：用免疫比浊法测定单纯慢性阻塞性肺疾病（COPD）患者，慢性肺源性心脏病（CPHD）急性加重期和临床缓解期患者的血浆D-二聚体含量，同时用免疫荧光法检测各组患者的B型脑钠肽水平，用血气分析仪测定各组患者的pH值、动脉血氧压（PaO2）、动脉二氧化碳分压（PaCO2），观察比较各组BNP、D-dimer含量的差异和进行动脉血气分析。结果：慢性肺源性心脏病患者急性加重期和临床缓解期患者血浆D-二聚体含量分别为（2.74±0.87）μg/L、（2.09±0.77）μg/L，均较单纯性COPD组患者的（1.67±0.65）μg/L明显升高，差异均有统计学意义（P0.05）；CPHD急性加重期和临床缓解期患者BNP水平分别为（919.34±189.33）pg/mL、（213.60±31.74）pg/mL，较单纯性COPD组患者（37.30±12.74）pg/mL明显增高，各组比较差异均有统计学意义（P0.01）。BNP、D-dimer含量与PaO2呈负相关，与PaCO2呈正相关（P0.05）。结论：联合检测B型脑钠肽和D-二聚体水平变化对慢性肺源性心脏病患者病情变化、疗效监测及预后有重要的临床意义。 　　【关键词】 慢性肺源性心脏病； B型脑钠肽； D-二聚体 　　Clinical Significance of B Type Natriuretic Peptide and D-dimer in Patients with Chronic Pulmonary Heart Disease Detection/GUO Chun-xia.//Medical Innovation of China，2013，10（35）：001-003 　　【Abstract】 Objective：To study the B-type natriuretic peptide （BNP） and D- dimer （D-dimer） levels in patients with chronic pulmonary heart disease（CPHD） and analyze its clinical significance.Method：Plasma D-dimer content by nephelometry and B-type natriuretic peptide levels by immunofluorescence assay were detected in patients with simple chronic obstructive pulmonary disease （COPD），chronic pulmonary heart disease （CPHD） in acute exacerbation and remission respectively，pH value，PaO2 and PaCO2 were determined by blood gas analyzer.Differences of the content of BNP，the D-dimer levels and arterial blood gas analysis were observed and compared among the groups.Result：Plasma D-dimer content in patients with chronic pulmonary heart disease in acute exacerbation and remission were（2.74±0.87）μg/L，（2.09±0.77）μg/L respectively，they were significantly higher than that in patients with simple obstructive pulmonary disease [（1.67±0.65）μg/L]，there were statistically significant differences（P0.05）.The BNP levels showed significant difference among the groups of patients with CPHD in acute exacerbation and remission was（919.34±189.33）pg/mL，（213.60±31.74）pg/mL，they were