AECOPD心衰患者BNP、cTnI的变化及与心功能关系

Changes of serum BNP and cTnI in patients with chronic obstructive pulmonary disease with heart failure and their relationship with heart function

目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)并充血性心力衰竭(CHF)患者血清脑钠素(BNP)、心肌肌钙蛋白I(cTnI)变化及与心功能关系。方法选择住院的AECOPD患者65例,其中合并CHF组30例,无CHF组35例。于治疗前后,用ELISA、RIA法测定血清BNP、cTnI含量;彩色多普勒超声心动图(CDE)测定左室射血分数(LVEF)、左室短轴缩短率(LVFS);SPSS13.0软件分析数据。结果治疗前,CHF组血清BNP、cTnI含量明显升高,LVEF和LVFS水平降低,与无CHF组比较有显著性差异(P<0.01);CHF组BNP、cTnI与LVEF、LVFS均呈直线负相关。治疗后,CHF组血清BNP、cTnI含量明显降低,LVEF、LVFS水平升高(P<0.01)。结论血清BNP、cTnI含量作为诊断AECOPD合并CHF的指标具有很好的临床价值。

Objective To investigate the changes of serum brain natriuretic peptide（BNP） and cardiac troponin I（cTnI） in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD） with congestive heart failure（CHF） and their relationship with heart function.Methods Thirty patients with AECOPD with CHF and thirtyfive patients without CHF were selected.Before and after treatment,the serum BNP and cTnI concentrations were measured by ELISA and RIA.Left ventricular rejection fraction（LVEF） and left ventricular fractional shortening（LVFS） were detected by color Doppler echocardiography（CDE）.SPSS 13.0 software was used to analyze the data.Results Before treatment,the concentrations of serum BNP and cTnI in patients with CHF increased significantly compared with those without CHF（P 0.01）,while their LVEF and LVFS decreased significantly（P 0.01）.BNP and cTnI correlated negatively with LVEF and LVFS in patients with CHF.After treatment,the concentrations of serum BNP and cTnI in patients with CHF decreased significantly compared with those of pre-treatment（P 0.01）,while their LVEF and LVFS increased significantly（P 0.01）.Conclusions Serum BNP and cTnI concentrations can be used as sensitive and specific index for the diagnosis of AECOPD complicated with CHF.