探讨肺心病急性加重期与慢性重度心力衰竭脑钠素的水平及意义

目的探讨慢性肺源性心脏病患者急性加重期与慢性重度心力衰竭患者血浆脑钠素(BNP)水平及临床意义。方法用免疫荧光法定量测定血浆BNP,慢性重度心力衰竭患者(心衰组)41例,慢性阻塞性肺病(COPD)合并肺心病急性加重期患者(肺心病组)31例,健康对照者(对照组)31例。并在肺心病组监测血气分析。结果心衰组血浆BNP(889.41±606.38)ng/L,肺心病组(374.00±377.95)ng/L,分别与对照组(12.08±9.24)ng/L比较差异有显著性(P<0.05),心衰组与肺心病组比较差异亦有显著性(P<0.05);肺心病组血浆BNP与PO2、PH、PCO2之间均无相关性(P>0.05)。结论血浆BNP升高参与肺心病的病理生理过程,并可用于鉴别心源性和肺源性呼吸困难。

Objective To study the clinical significance of plasma brain natriuretic peptide（BNP） levels in patients with chrortie pulmonary heart disease arid patients with congestive heart failure （CHF）. Methods The levels of BNP in control group（31 cases）, chronic pulmonary heart disease group （PHD） （31 cases）, CHF group（ 41 eases ） were measured by immonofluorrescence. The blood gas in PHI） group were measured. Re.tiltS The levels of BNP in the group of CHF （889.41±606.38） ng,/L and PHD （374.00 ±377.95） ng/l, were significantly higher than that in the normal group（ 12,08 ± 9,24） ng/ L（p 〈 0,05） ; the levels of BNP in the group of CHF was significantly higher than that in the group of PHD. The level of BNPS was not correlated with PO2, PH, and PCO2. Condusion BNP involves in the pathophysiology of cor puhnonale, and may be used in the differentiation of acute dyspnea due to ptthnonary and cardiac causes.