COPD合并肺心病患者的血浆BNP与D-二聚体变化及临床意义

Changes of plasma BNP and D-dimer in patients with COPD complicated with pulmonary heart disease and its clinical significance

目的探讨慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)合并肺心病患者血浆B型尿钠肽(BNP)、D-二聚体水平变化及临床意义。方法选择本院收治的COPD合并肺心病患者78例,其中42例出现右心衰竭作为右心衰竭组,36例缓解期患者作为缓解期组,同期体检的健康人40例作为对照组,比较各组血浆BNP、D-二聚体水平,以及不同右心功能、不同肺动脉高压患者BNP、D-二聚体水平。结果各组血浆BNP、D-二聚体水平差异有统计学意义,右心衰竭组血浆BNP、D-二聚体显著高于缓解期组和对照组,缓解期组血浆BNP、D-二聚体显著高于对照组(P<0.05)。不同右心功能患者血浆BNP、D-二聚体水平比较差异有统计学意义(P<0.05),Ⅰ～Ⅱ级组、Ⅲ～Ⅳ级组患者血浆BNP、D-二聚体显著高于0级组患者,Ⅰ～Ⅱ组患者血浆BNP、D-二聚体显著高于0级组患者(P<0.05)。不同肺动脉高压患者血浆BNP、D-二聚体水平比较差异有统计学意义,重度组、中度组患者血浆BNP、D-二聚体显著高于轻度组患者,中度组患者血浆BNP、D-二聚体显著高于轻度组患者(P<0.05)。结论 COPD合并肺心病患者血浆BNP、D-二聚体水平均异常升高,患者心功能越低、肺动脉压越高则血浆BNP、D-二聚体水平越高。

Objective To investigate the change and clinical significance of plasma B type natriuretic peptide(BNP)and D-dimer in patients with chronic obstructive pulmonary disease(COPD)and pulmonary heart disease.Methods Selected 78 COPD patients with pulmonary heart disease admitted to our hospital,including 42 cases of right heart failure as right heart failure group,36 patients were in remission patients as the remission group,healthy check-up in 40 cases as control group,comparison of plasma BNP,D-dimer and two level.Different right ventricular function in patients with pulmonary hypertension,BNP,D-dimer level.Results There were significant differences in plasma BNP and D-dimer in all groups.The plasma BNP and D-dimer in the right heart failure group were significantly higher than those in the remission phase group and the control group.The plasma BNP and D-dimer in the remission group were significantly higher than those in the control group(P<0.05).The plasma levels of BNP and D-dimer in patients with different right heart function were statistically different.Plasma BNP and D-dimerin group I and groupⅢwere significantly higher than those in group 0,andⅠandⅡin group I were significantly higher than those in group 0.Plasma levels of BNP and D-two dimers in patients with different pulmonary hypertension were statistically different(P<0.05).Plasma BNP and D-dimer in severe group and moderate group were significantly higher than those in mild group.Plasma BNP and D-two polymers in moderate group were significantly higher than those in mild group(P<0.05).Conclusion The levels of plasma BNP and D-two dimers in patients with COPD and cor pulmonale are increased.The higher the heart function and the higher the pulmonary arterial pressure,the higher the level of plasma BNP and D-dimer.