N端脑利钠肽前体在老年慢性肺源性心脏病诊断中的意义

Significance of N-terminal Pro-brain Natriuretic Peptide in the Diagnosis of Elderly Chronic Pulmonary Heart Disease

目的分析N端脑利钠肽前体(NT-proBNP)与血气分析、心脏彩超指标之间相关性,探讨NT-ProBNP在慢性肺源性心脏病(CPHD)急性加重期临床早期诊治过程中的意义。方法选取2016年10月~2018年6月入住于淮安市中医院呼吸科的CPHD急性加重期患者共62例设为A组,另选择同期住院的慢性阻塞性肺疾病急性加重期患者(AECOPD)58例设为B组,比较两组血浆NT-proBNP、血气分析(pH、PO2、PCO2)及心脏彩超(RV、RVOT、LVEF、PAP),探讨血浆NT-proBNP浓度与血气分析、心脏彩超相关指标的相关性。结果A组血浆NT-proBNP浓度、PO2、RV、RVOT、PAP水平均高于B组(P<0.05);A组的pH、PO2水平低于B组(P<0.05);两组LVEF水平比较,差异无统计学意义(P>0.05);Pearson相关分析显示,pH、PO2分别与血NT-proBNP水平呈负相关,PCO2、RV、RVOT、PAP分别与NT-proBNP水平呈正相关。结论血浆NT-proBNP可反映慢性肺源性心脏病(CPHD)急性加重期患者右心室负荷情况,以及对缺氧、二氧化碳潴留、酸碱平衡紊乱等疾病严重程度的评估,具有临床早期评估病情的参考意义。

Objective To analyze the correlation between N-terminal brain natriuretic peptide(NT-proBNP),blood gas analysis,and cardiac color Doppler ultrasound indicators,to explore the significance of NT-ProBNP in the early clinical diagnosis and treatment of acute exacerbation of chronic cor pulmonale(CPHD).Methods A total of 62 patients with acute exacerbation of CPHD who were admitted to the Department of Respiratory Medicine of Huai'an Hospital of Traditional Chinese Medicine from October 2016 to June 2018 were selected as group A,and patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)who were hospitalized during the same period were selected as group A.58 cases were set as group B.The plasma NT-proBNP,blood gas analysis(PH,PO2,PCO2)and cardiac color Doppler ultrasound(RV,RVOT,LVEF,PAP)were compared between the two groups to explore the correlation between plasma NT-proBNP concentration and blood gas analysis and cardiac color Doppler ultrasound.The relevance of indicators.Results The plasma NT-proBNP concentration,PCO2,RV,RVOT and PAP levels of group A were higher than those of group B(P<0.05);the levels of PH and PO2 of group A were lower than group B(P<0.05);There was no statistically significant difference in LVEF levels between the two groups(P>0.05);Pearson correlation analysis showed that PH and PO2 were negatively correlated with blood NT-proBNP levels,PCO2,RV,RVOT,and PAP respectively was positively correlated with NT-proBNP level.Conclusion Plasma NT-proBNP could reflect the right ventricular load in patients with acute exacerbation of chronic cor pulmonale(CPHD),as well as the assessment of the severity of hypoxia,carbon dioxide retention,acid-base balance disorders and other diseases,and it was a reference for early clinical evaluation of the disease significance.