利尿剂及扩血管药物对慢性阻塞性肺病急性发作患者的影响

The effection of diuretic and vasodilator on patients with an acute exacerbation of chronic obstructive pulmonary disease

目的评价静脉联合应用利尿剂及扩血管药物对于COPD急性发作(AECOPD)患者血浆BNP水平的影响。方法入选20名BNP水平升高的AECOPD患者,经临床证实不存在肺心病,随机分为2组(组Ⅰ及组Ⅱ),每组包含10名患者,在常规AECOPD治疗基础上,Ⅰ组患者加用利尿剂,Ⅱ组患者加用利尿剂及扩血管药物,10例稳定期COPD患者作为对照组。上述患者均于入院时、入院第5天、第10天测定BNP浓度。并测定血常规、血气分析、肺功能等指标。结果AECOPD患者血浆BNP浓度在治疗后明显下降,且Ⅱ组较Ⅰ组患者下降更为明显。且对肺功能、血离子等无明显不良影响。结论 AECOPD患者经利尿剂及扩血管药物治疗后血浆BNP水平迅速下降。且对肺功能、血离子等无明显不良影响。

【Objective】 Evaluate the effects of a diuretic and a vasodilator on plasma brain natriuretic peptide（BNP） levels in patients with an acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.【Methods】 20 patients were selected,who had an AECOPD with high plasma BNP but without any clinical evidence of cor pulmonale.They were randomLy divided into two groups,groupⅠandⅡ,each contained 10 patients.In addition to standard treatment for AECOPD,the patients in groupⅠwere treated with a mild diuretic,and those in group Ⅱ were treated with a diuretic and a vasodilator.10 patients with stable COPD were selected as the control group.Plasma BNP concentrations were measured on admission and on the fifth and tenth day after that.Blood routine,arterial blood gas analysis,lung function and other indicators were also determined.【Resluts】Plasma BNP concentrations in patients with AECOPD were decreased significantly after treatment,and this decrease was more striking in group Ⅱ than in group Ⅰ,without obvious adverse effect on lung function and blood ions.【Conclusion】Plasma BNP levels in patients with an AECOPD decreased rapidly after therapy with a diuretic and a vasodilator,and without obvious adverse effect on lung function and blood ions.