血清B型钠尿肽水平对早期慢性阻塞性肺疾病左心功能的预测价值

The predictive value of serum B-type natriuretic peptide for the left ventricle function at early stage of chronic obstructive pulmonary disease

目的探讨血清B型钠尿肽(BNP)水平对早期慢性阻塞性肺疾病(COPD)患者左心功能的预测作用。方法选取2013年1月至2014年2月我院收治的早期COPD患者60例为观察组,对照组为30例同期健康体检者。观察组在常规治疗前后检测BNP水平,对照组直接检测血清BNP水平。观察两组患者血清BNP水平、左心室射血分数(LVEF)、第一秒用力肺活量(FEV1)、用力肺活量(FVC)以及血清BNP水平与LVEF的相关性。结果观察组血清BNP水平与治疗前比较显著下降,与对照组比较显著升高(P<0.05)。两组FEV1、FVC和LVEF比较差异有统计学意义(P<0.05)。血清BNPROC曲线下面积为0.806。随着观察组患者BNP水平的升高,LVEF降低,二者呈显著相关(r=-0.802,P<0.05)。结论早期COPD患者已出现血清BNP升高和LVEF降低,左心功能已受到影响。

Objective To investigate the predictive value of serum B-type natriuretic peptide（BNP） for the left ventricle function at early stage of chronic obstructive pulmonary disease（COPD）.Methods Sixty patients with early COPD treated in our hospital between Jan 2013 and Feb 2014 were selected as observation group.Thirty normal healthy subjects of the same age were used as control group.Serum BNP levels of patients in the observation group were measured before and after treatment.The serum BNP level in the control group was also tested.The serum BNP levels,LVEF,FEV1,FVC and the relationship between the serum BNP levels and LVEF were compared.Results Compared with before treatment,the serum BNP levels in the observation group were significantly decreased.Compared with the control group,the serum BNP levels in the observation group were significantly increased（P〈 0.05）.The differences in FEV1,FVC and LVEF between the two groups were also statistically significant（P〈 0.05）.The area under the ROC curve of serum BNP was 0.806.With the increase of BNP levels of the patients in the observation group,LVEF was decreased.There was a significant correlation between the two parameters（r =-0.826,P 〈0.05）.Conclusion At early stage of COPD,serum BNP level is increased while LVEF is decreased suggesting that heart function has been influenced.