N-端脑钠肽前体与慢性阻塞性肺疾病急性加重老年患者肺动脉压的相关性分析

The correlation analysis between N-terminal pro-brain natriuretic peptide and pulmonary arterial pressure in elder patients with acute exacerbation of chronic obstructive pulmonary disease

目的:分析在慢性阻塞性肺疾病(COPD)急性加重(AECOPD)老年患者中N-端脑钠肽前体(NTproBNP)等指标与肺动脉压(PAP)的相关性。方法:选取2019年1月—2021年2月云南省大理白族自治州人民医院收治的AECOPD老年患者152例作为病例组,COPD稳定期老年患者112例作为对照组。所有患者在入院24 h内完成血气分析、凝血功能、D-二聚体、NT-proBNP等检验项目,48 h内进行超声心动图检查测定肺动脉收缩压(PASP)。对两组患者的氨基末端脑钠肽前体(NT-proBNP)、氧分压(PO_(2))、二氧化碳分压(PCO_(2))、纤维蛋白原(FIB)、D-二聚体(D-Dimer)、肺动脉收缩压(PASP)进行组间比较。对NT-proBNP、PO_(2)、PCO_(2)、FIB、D-Dimer与PASP的关系进行相关性分析。结果:病例组的NT-proBNP、FIB、D-Dimer和PASP明显高于对照组,PO_(2)低于对照组,差异有统计学意义(P<0.05)。NT-proBNP与PASP呈正相关(P<0.05),PO_(2)与PASP呈负相关(P<0.05)。结论:在AECOPD老年患者中,NT-proBNP可反映肺动脉压的升高程度,可作为AECOPD老年患者合并肺动脉高压诊断和治疗的参考指标。

Objective To analysis the correlation between N-terminal pro-brain natriuretic peptide and pulmonary arterial pressure(PAP)in elder patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 152 elderly patients with AECOPD admitted to the People’s Hospital of Dali Bai Autonomous Prefecture,Yunnan Province from January 2019 to February 2021,as case group,112 patients with stable COPD,as control group.All patients were completed blood gas analysis,coagulation function,D-dimer,NT-proBNP and other test items within 24 hours of admission,and underwent echocardiography to measure pulmonary artery systolic pressure(PASP)within 48 hours.The N-terminal pro-brain natriuretic peptide(NT-proBNP),partial pressure of oxygen(PO2),partial pressure of carbon dioxide(PCO2),fibrinogen(FIB),D-dimer and pulmonary artery systolic pressure(PASP)were compared between the two groups.Correlation analysis was performed on NT-proBNP,PO2,PCO2,FIB,D-Dimer and PASP.Results In case group,NT-proBNP,FIB,D-Dimer,and PASP were clear increased,PO2 decreased(P<0.05).NT-proBNP was positively correlated with PASP,and PO2 was negatively correlated with PASP(P<0.05).Conclusion The level of N-terminal pro-brain natriuretic peptide could indicate the severity of pulmonary arterial pressure in elder people with acute exacerbation of chronic obstructive pulmonary disease,it could be a index of diagnosis and treatment of pulmonary arterial hypertension.