血浆B型脑钠肽水平在慢性阻塞性肺疾病近远期治疗预后评估中的价值

Value of plasma B natriuretic peptide level in the short and long-term prognosis of patients with chronic obstructive pulmonary disease

目的探讨血浆B型脑钠肽(BNP)水平在慢性阻塞性肺疾病(慢阻肺)近远期治疗预后评估中的价值。方法选择2013年12月到2016年1月在重庆市第九人民医院住院的慢阻肺患者250例作为慢阻肺组,选择同期正常健康人250例作为对照组,两组都进行血浆BNP检测,同时进行肺功能、血气分析与近远期预后随访与相关性分析。结果慢阻肺组与对照组的血浆BNP含量分别为(567.33±56.38)pg/mL和(95.67±25.35)pg/mL,慢阻肺组的血浆BNP含量明显高于对照组(P<0.05)。慢阻肺组的FEV_1%、FEV_1/FVC和PO_2值都明显低于对照组(P<0.05),两组的VC%、pH和PCO_2值对比差异无统计学意义(P>0.05)。慢阻肺组的住院时间与门诊次数分别为8.56±1.24d和2.45±0.22次,都明显多于对照组的2.11±1.03d和0.48±0.23次(P<0.05);Spearman相关性分析结果显示BNP与住院时间、门诊次数都呈现明显正相关性(r=0.342,0.298,P<0.05);多变量Logistic回归分析结果表明BNP(OR=20.588,95%CI 5.029-84.279,P<0.05)也为影响近远期预后的主要危险因素(P<0.05)。结论血浆BNP水平在慢阻肺患者中呈现高表达状况,是反映患者病情与治疗近远期预后良好指标,在临床上具有很好的评估价值。

Objective To investigate the value of plasma B natriuretic peptide （BNP） level in patients with chronic obstructive pulmonary disease （COPD）. Methods From December 2013 to January 2016, it selected 250 COPD patients hospitalized in the Ninth Peopleg Hospital of Chongqing as the COPD group, and 250 healthy people as the control group at the same period. Their plasma BPN was detected, and its correlation with lung function, blood gas analysis and short and long-term prognosis was analyzed. Results The plasma BNP level in the COPD group and the control group was 567.33 ± 56. 38pg/mL and 95.67 ± 25.35pg/mL respectively （P 〈 0.05 ）. The values of FEV1%, FEV1/FVC and PO2 in the COPD group were significantly lower than those in the control group （P 〈 0. 05 ）, and there was no significant difference in VC%, pH and PCO2 values between the two groups （P 〉 0. 05 ）. The duration of hospital stay and outpatient visits were 8.56 ± 1.24 and 2.45 ± 0. 22 times in the COPD group, which were significantly higher than those in the control group （ 2. 11 ± 1.03d and 0. 48 ± 0. 23 times） （ P 〈 0. 05 ）. Spearman correlation analysis showed that BNP was significantly positively correlated with the duration of hospital stay and outpatient visits （r = 0. 342,0. 298, P 〈 0.05 ）. Multi-variable logistic regression analysis results showed that BNP （ OR = = 20. 588, 95% CI 5. 029 - 84. 279, P 〈 0. 05） was also the major risk factor for the effect of short and long-term prognosis （P 〈 0. 05）. Conclusion The plasma BNP is high expressed in COPD patients, and it is a good indicator to reflect the patient; condition and treatment of short and long-term prognosis.