脑钠肽水平在慢性阻塞性肺疾病急性加重期和左心功能不全患者中的临床意义

The clinical significance of serum brain natriuretic peptide in patients with acute exacerbation of chronic obstructive pulmonary disease and patients with left ventricular dysfunction

目的探讨慢性阻塞性肺疾病(COPD)急性加重期和左心功能不全患者血浆中脑钠肽(BNP)水平和临床意义。方法住院治疗的55例左心功能不全患者和COPD患者,在其入院时测得BNP水平,进行相关性分析。结果左心功能不全患者BNP水平明显高于COPD患者(P<0.01);BNP浓度与第一秒钟用力呼气容积(FEV1)/预计值百分比呈负相关(r=-0.868,P<0.01);BNP浓度与LVEF之间呈负相关(r=-0.929,P<0.01);BNP>200 pg/ml时左心功能不全患者数目大于COPD患者。结论左心功能不全的患者BNP水平明显高于COPD急性加重期患者,BNP能帮助鉴别COPD急性加重期与左心功能不全。

Objective To study the clinical significance of serun brain natriuretic peptide change in patients with acute exacerbation of chronic obstructive pulmonary disease and patients with left ventricular dysfunction. Methods Retrospective medical records analysis of all patients hospitalized from January 2008 to May 2011 with the final diagnosis of acute exacerbation of COPD and left ventricular dysfunction, and who had undergone serum BNP test at admission. Results The serum BNP levels in patients with left ventricular dysfunction was significantly higher than patients with COPD （P 〈 0.01 ）. BNP levels were negatively correlated with FEV1 （% of predicted value, r = -0.868 ,P 〈0.001 ）. BNP levels were negatively correlated with LVEF（r = -0. 868 ,P 〈0.001 ）. BNP 〉 200pg/ml, the number of patients with left ventricular dysfunction was greater than that of patients with COPD. Conclusion The serun BNP detection can help physicians in identifying heart failure in patients suffering from an acute exacerbation of COPD.