血浆BNP水平对老年COPD患者肺动脉高压的临床意义

Clinical Significance of Plasma BNP Level in Pulmonary Hypertension in Elderly COPD Patients

目的:探讨血浆脑钠肽(BNP)水平对老年慢性阻塞性肺疾病(COPD)患者肺动脉高压(PAH)的临床表达意义。方法:选取我院2017年1月至2017年收治的75例老年COPD患者和30例同期来院体检的健康同龄人,年龄均≥60岁,分别记为COPD组和对照组。根据肺动脉收缩压(PASP)检测水平将COPD组分别非PAH组(PASP≤35mm Hg)36例、PAH组(PASP>35mm Hg)39例,将PAH组进一步分为轻度组(35mm Hg<PASP≤50mm Hg)14例、中度组(50mm Hg<PASP≤70mm Hg)15例、重度组(PASP>70mm Hg)10例。观察上述不同组别COPD患者血BNP表达特点,并分析血BNP和PASP水平的内在相关性。结果:COPD组血BNP、PASP水平均高于对照组,差异具有统计学意义(P<0.05);COPD合并PAH组血BNP、PASP水平高于非PAH组,差异具有统计学意义(P<0.05);轻度、中度、重度PAH亚组血BNP、PASP水平相较差异具有统计学意义(P<0.05),Peaeson直线相关分析和偏相关分析排除性别、年龄因素后,血BNP、PASP水平呈显著正相关(P<0.05)。结论:老年COPD患者血BNP呈异常升高状态,且合并PAH时表现更为明显;血BNP和PASP水平呈显著正相关关系,对帮助临床评估PAH风险、病情程度具有重要指导意义。

Objective:To investigate the clinical significance of plasma brain natriuretic peptide(BNP)level in elderly patients with chronic obstructive pulmonary disease(COPD)with pulmonary hypertension(PAH).Methods:75 aged COPD patients and 30 healthy peers who were enrolled in the hospital during the period of^2017 in January 2017 were selected as the COPD group and the control group.According to the detection level of pulmonary artery systolic pressure(PASP),39 cases of group COPD were not PAH(PASP<35mmHg),and PAH group(PASP>35mmHg)were divided into 14 cases of mild group(35mmHg<PASP<50mmHg),15 cases of moderate group and 10 cases of severe group.The BNP expression characteristics of COPD in the above groups were observed,and the correlation between BNP and PASP levels was analyzed.Results:The blood BNP and PASP levels in group COPD were higher than those in the control group,and the difference was statistically significant(P<0.05).The level of BNP and PASP in COPD combined with PAH group was higher than that in the non PAH group,and the difference was statistically significant(P<0.05).Linear correlation analysis and partial correlation analysis excluded gender and age factors,and there was a significant positive correlation between BNP and PASP levels(P<0.05).Conclusion:The blood BNP of the elderly COPD patients showed an abnormal rising state,and the expression was more obvious with the combination of PAH;the blood BNP and PASP levels were significantly positive correlation,which was of important guiding significance for the clinical assessment of the risk of PAH and the degree of the disease.