慢性阻塞性肺疾病合并不同类型心功能不全者脑钠肽水平比较

The Comparison of Brain Natriuretic Peptide Levels in Patients with Chronic Obstructive Pulmonary Disease Combined with Different Types of Heart Insufficiency

目的比较慢性阻塞性肺疾病(COPD)合并不同类型心功能不全患者的血浆脑钠肽水平,以探讨其临床应用价值。方法选择2009年3月至2012年10月由南方医科大学附属小榄人民医院收治的COPD患者86例,根据患者病情分为两组:合并肺源性心脏病右心功能不全者为A组44例,合并左心功能不全者为B组42例,分别测定两组患者的血浆脑钠肽水平进行比较,并分析两组患者血浆脑钠肽水平与纽约心脏病协会(NYHA)分级的相关性。结果 A、B两组脑钠肽水平分别为(635.8±179.3)ng/L和(954.4±281.6)ng/L,A组显著低于B组(t=6.288,P<0.01)。相同程度心功能不全时,A组脑钠肽水平显著低于B组(P<0.01),两组血浆脑钠肽水平均与NYHA分级存在显著正相关。结论 COPD患者合并不同类型心功能不全时,其血浆脑钠肽水平升高程度也不同,检测其血浆脑钠肽水平,对发现其心功能不全、判断病情有积极意义。

Objective To contrast brain natriuretic peptide levels in patients with chronic obstructive pulmonary disease（COPD） combined with different types of heart insufficiency.Methods Eighty-six patients with COPD who stayed in Affiliated Xiaolan People＇s Hospital of Southern Medical University during March 2009 and October 2012 were enrolled in the study.The patients were divided into two groups according to their condition： 44 of them（Group A） were combined with right heart insufficiency caused by pulmonary heart disease,the other 42 patients（Group B） had left heart insufficiency.Brain natriuretic peptide levels in plasma of all patients were detected,and its correlation with NYHA grade was analyzed in the two groups.Results The brain natriuretic peptide levels of group A and group B were（635.8 ± 179.3） ng / L and（954.4 ± 281.6） ng / L respectively,and there was significant difference between them（t = 6.288,P 0.01）.When they were in the same degree of heart insufficiency,the brain natriuretic peptide levels in group A were significantly lower than those in group B（P 0.01）.The brain natriuretic peptide levels correlated significantly with NYHA grade in both groups.Conclusion The increased degree of plasma brain natriuretic peptide levels is closely related with the types of heart insufficiency.The detection of brain natriuretic peptide has a positive significance in screening heart insufficiency and assessing the disease condition.