慢性肺源性心脏病失代偿期患者NT-proBNP和肌钙蛋白Ⅰ的表达及其临床意义

Expression levels of specificity and its clinical significance of NT-proBNP and troponin Ⅰ in patients with chronic pulmonary heart disease in decompensatory stage

目的研究慢性肺源性心脏病失代偿期患者的N-脑钠肽前体(NT-proBNP)和肌钙蛋白Ⅰ表达水平及其临床意义。方法选择2010年2月～2012年4月收治的慢性肺源性心脏病患者165例为研究组,检测其NT-proBNP和肌钙蛋白Ⅰ表达水平,其中48例为慢性肺源性心脏病失代偿期患者,117例为慢性肺源性心脏病代偿期患者,另选择45例健康体检者作为对照组。研究NT-proBNP和肌钙蛋白Ⅰ检测在慢性肺源性心脏病失代偿期的临床意义。结果研究组慢性肺源性心脏病代偿期和失代偿期患者NT-proBNP水平[(431.8±205.96)、(1684.49±370.74)ng/L]均明显高于对照组[(46.57±29.92)ng/L],且失代偿期患者NT-proBNP水平高于代偿期患者,差异均有统计学意义(均P<0.05)。研究组慢性肺源性心脏病代偿期和失代偿期患者肌钙蛋白Ⅰ水平[(0.68±0.25)、(1.35±0.28)μg/L]均高于对照组[(0.05±0.01)μg/L],且失代偿期患者肌钙蛋白Ⅰ水平明显高于代偿期患者,差异均有统计学意义(均P<0.05)。慢性肺源性心脏病代偿期与失代偿期患者FEV1/FVC、FEV1%预计值比较,差异无统计学意义(P>0.05);慢性肺源性心脏病失代偿期患者NT-proBNP水平[(1684.49±370.74)ng/L]高于代偿期患者[(431.8±205.96)ng/L],差异有统计学意义(P<0.05)。心力衰竭Ⅲ级患者NT-proBNP、肌钙蛋白Ⅰ水平[(1578.74±350.37)ng/L、(1.25±0.27)μg/L]高于心力衰竭Ⅱ级患者[(957.56±382.87)ng/L、(7.94±0.18)μg/L],差异均有统计学意义(P<0.05);心力衰竭Ⅳ级患者NT-proBNP、肌钙蛋白Ⅰ水平[(2452.98±468.45)ng/L、(2.36±0.25)μg/L]高于心力衰竭Ⅲ级患者,差异均有统计学意义(P<0.05)。结论 NT-proBNP和肌钙蛋白Ⅰ的检测对于慢性肺源性心脏病失代偿期的诊断和治疗具有一定的指导意义。

Objective To explore the expression levels of specificity and its clinical significance of NT-proBNP and cardiac troponinin in patients with deeompensated chronic pulmonary heart disease. Methods 165 patients with chronic pulmonary heart disease from February 2012 to April 2010 were selected as research group, the cardiac tro- ponin I and NT-proBNP expression levels were detected, 48 cases of chronic pulmonary heart disease were found in decompensatory stage, 117 cases of chronic pulmonary heart disease in compensatory stage were found in research group, the other 45 healthy subjects were chosen as control group, and the expression levels of specificity and clinical significance of NT-proBNP and cardiac troponinin [ were researched. Results NT-proBNP level in compensatory stage and decompensatory stage of research group [（431.8±205.96）, （1684.49±370.74） ng/L] were all higher than those in control group [（46.57±29.92） ng/L], NT-proBNP level in compensatory stage were higher than that in decompensatory stage, the differences were all statistically significant （P 〈 0.05）. Cardiac troponinin I in compensatory stage and decompensatory stage of research group [（0.68±0.25）, （1.35±0.28） tzg/L] were all higher than those in control group [（0.05±0.01） μg/L], cardiac troponinin I in compensatory stage were higher than that in decompensatory stage, the differences were all statistically significant （P 〈 0.05）. The differences of FEV1/FVC and FEV1% predicted value in compensatory stage and decompensatory stage of research group were not statistically significant （P 〉 0.05）. The expression levels of NT-proBNP and cardiac troponin I in heart failure of IU grade [（1578.74±350.37） ng/L, （1.25±0.27） μg/L] were all higher than those in heart failure of I1 grade [（957.56±382.87） ng/L, （7.94±0.18） μg/L], the differences were all statistically significant （P 〈 0.05）; expression levels of NT-proBNP and cardiac troponin I in heart fail-ure of IV grade [（2452.98±468.45） ng/L, （2.36±0.25）μg/L] were all higher than those in heart failure of 11I grade, the differences were all statistically significant （P 〈 0.05）. Conclusion NT-proBNP and troponin testing for diagnosis and treatment of chronic pulmonary heart disease patients in decompensatory stage have certain guiding significance