脑钠肽在慢性左心衰竭与肺源性心脏病的诊断及治疗中的价值

Value of Brain Natriuretic Peptide for the Diagnosis and Treatment of Chronic Left Heart Failure and Cor Pulmonale

目的:探讨高血压伴慢性左心衰竭患者与慢性阻塞性肺病(chronic obstructive pulmonary disease,COPD)合并肺源性心脏病(cor pulmonale,CP)患者的血浆脑钠肽(brain natriuretic peptide,BNP)的变化及其对治疗评估的价值。方法:以上海市第二人民医院2010年11月—2013年11月收治的高血压伴慢性左心衰竭患者36例、COPD伴CP患者34例为研究对象,并同时选择心肺功能正常者30例作为对照组。定量检测治疗前后各组的血浆BNP水平。结果:高血压伴慢性左心衰竭组及COPD伴CP组治疗前血浆BNP水平均高于对照组(P<0.05),治疗前高血压伴慢性左心衰竭组血浆BNP水平高于COPD伴CP组(P<0.05);治疗后高血压伴慢性左心衰竭组和COPD伴CP组血浆BNP水平均较治疗前下降(P<0.05),高血压伴慢性左心衰竭组血浆BNP水平高于COPD伴CP组(P<0.05)。结论:BNP可作为CP和慢性左心衰竭的鉴别诊断及治疗评估指标。

Objective：To investigate the variation of plasma braln natriuretic peptide（BNP） and its value for diagnosis and treatment in patients with hypertension accompanied by chronic left heart fallure or chronic obstructive pulmonary disease （COPD） accompanied by cor pulmonale（CP） .Methods：A total of 36 patients with hypertension accompanied by chronic left heart fallure and 34 patients with COPD accompanied by CP ,who were admitted to Shanghal Second People’s Hospital from Nov 2010 to Nov 2013 ,were enrolled as study subjects .Meanwhile ,30 normal control were enrolled .Quantitative detection of plasma BNP level was done in each group before and after the treatment .Results：The levels of plasma BNP in the hypertension accompanied by chronic left heart fallure group and the COPD accompanied by CP group before the treatment were higher than that in the control group（P〈0 .05） .The levels of plasma BNP in the hypertension accompanied by chronic left heart fallure group was higher than that in the COPD accompanied by CP group before the treatment（P〈 0 .05） .After the treatment ,the levels of plasma BNP in both the hypertension accompanied by chronic left heart fallure group and the COPD accompanied by CP group decreased （P〈0 .05） .The level of plasma BNP in the hypertension accompanied by chronic left heart fallure group was higher than that in the COPD accompanied by CP group after the treatment（P〈0 .05） .Conclusions：BNP can be used as the index for differential diagnosis and therapeutic effect assessment of CP and chronic left heart fallure .