B型钠尿肽联合C反应蛋白在慢性阻塞性肺疾病合并心功能不全中的评估作用

Value of B type natriuretic peptide combined with C reactive protein in the evaluation of chronic obstructive pulmonary disease complicated with cardiac insufficiency

目的:探讨B型钠尿肽(BNP)联合C反应蛋白(CRP)在慢性阻塞性肺疾病(COPD)合并心功能不全中的作用。方法:选择60例COPD合并心功能不全病人60例,根据病情分为观察A组和观察B组,观察A组病人合并左心功能不全,观察B组病人合并右心功能不全。选择同期COPD不合并心功能不全病人53例为对照组。分别测定3组病人BNP和CRP水平。结果:观察A组病人左心室射血分数低于对照组(P<0.01),左室内径高于对照组(P<0.01);观察B组病人肺动脉压和右室内径均高于对照组(P<0.01)。观察A组和观察B组病人BNP及CRP水平均明显高于对照组(P<0.01),且观察A组病人BNP水平高于观察B组(P<0.01)。观察A组和观察B组病人治疗后CRP和BNP水平明显低于治疗前(P<0.05~P<0.01)。观察A组病人BNP和CRP水平与LVEF水平呈负相关关系(P<0.05);观察B组病人BNP和CRP水平与肺动脉压呈相关关系(P<0.05)。结论:检测BNP和CRP水平可以帮助鉴别诊断COPD病人是否合并心功能不全。

Objective:To investigate the value of B type natriuretic peptide(BNP) combined with C reactive protein(CRP) in the evaluation of chronic obstructive pulmonary disease(COPD) complicated with cardiac insufficiency. Methods:Sixty COPD patients complicated with cardiac insufficiency were divided into group A(left ventricular dysfunction) and group B(right cardiac insufficiency),and 53 COPD patients without cardiac insufficiency were set as the control group.The levels of BNP and CRP were measured in three groups. Results:The level of LVEF in group A was lower than that in control group( P <0.01),and the left ventricular diameter in group A was higher than that in control group( P <0.01).The pulmonary artery pressure and right ventricular diameter in group B were higher than those in control group( P <0.01).The levels of BNP and CRP in group A and group B were significantly higher than those in control group( P <0.01),and the level of BNP in group A was higher than that in group B( P < 0.01 ).The levels of BNP and CRP in group A and group B after treatment were significantly lower than those before treatment( P <0.05 to P <0.01).The levels of BNP and CRP in group A were negatively correlated with LVEF level( P <0.05),and the levels of BNP and CRP in group B were positively correlated with pulmonary artery pressure( P <0.05). Conclusions:The levels of BNP and CRP can help to identify the cardiac insufficiency in COPD patients.