N端脑钠肽前体与慢性阻塞性肺疾病相关性分析.docVIP

N端脑钠肽前体与慢性阻塞性肺疾病相关性分析 　　【摘要】 目的探讨N-端脑钠肽前体在慢性阻塞性肺疾病（COPD）中的变化及其意义。方法 117例确诊为COPD患者，分为单纯COPD组和COPD合并肺心病组，用电化学发光法测定血浆NT-ProBNP并比较其差异。结果 COPD合并肺心病组NT-ProBNP水平明显高于单纯COPD组，且NT-ProBNP水平在轻、中、重度肺动脉高压组间差异有统计学意义（P＜0．05）；NT-ProBNP与肺动脉收缩压、主肺动脉宽度、右心室前壁厚度、右心室舒张末内径有良好的相关性。结论 血浆NT-ProBNP浓度能较好地反映COPD患者的肺动脉高压情况及右心室功能状态。? 　　【关键词】COPD；肺心病；肺动脉高压；N-端脑钠肽前体 ?? 　　Correlation analysis between chronic obstructive pulmonary disease and N-terminal pro-brain natriuretic peptide WANG Lin-mei,XIA Xi-zheng,SHAO Yun-xia.The Second Affiliated Hospital of Zhengzhou Uni-versity,Henan 450014,China 　　?? 　　【Abstract】 Objective To study the change and the significance of N-terminal pro-brain natriuretic peptide in the COPD patients. Methods 117 COPD patients were selected and divided into the pure COPD group and the COPD with chronic pulmonary heart disease group . NT-ProBNP was measured by using electrochemiluminescence law and its difference was compared finally. ResultsNT-ProBNP in the COPD with chronic pulmonary heart disease group was higher than that in the pure COPD group （P＜0．01）; group mild pulmonary hypertension,group moderate pulmonary hypertension and group sever pulmonary hypertension were compared in NT-ProBNP ,three groups were significantly differences（P＜0．05）. NT-ProBNP was related positively to pulmonary arterial systolic pressure , aortopulmonary width , right ventricular anterior wall thickness and right ventricular end-diastolic diameter . ConclusionNT-ProBNP plays an important role in the diagnosis of chronic pulmonary heart disease and reflects the pulmonary hypertension and right ventricular function status in COPD.? 　　【Key words】 COPD；Pulmonary heart disease;Pulmonary hypertension;NT-ProBNP 　　? 　　慢性阻塞性肺疾病急性加重期的患者是否存在肺源性心脏病（肺心病），心脏受累的程度如何。为了明确以上问题，除了心电图及胸部X线以外，超声心动图也是一项最重要的检查手段[1]。 但是许多医院不具备床旁超声条件，所以，寻求床边快速、简捷的诊断方法具有重要的临床意义。目前国内外对NT-ProBNP的相关报道，大部分集中在左心功能不全及引起左心室增大的相关疾病。本实验通过对COPD患者血浆NT-ProBNP的测定，探讨其在COPD疾病发展过程中的变化及临床指导意义。? 　　1 资料与方法? 　　1．1 一般资料 117例COPD患者为2006年2月至2008年5月在