NT-proBNP与呼吸衰竭及慢性肺源性心脏病的相关性研究

目的：研究N端脑钠肽前体（NT-ProBNP）与呼吸衰竭及慢性肺源性心脏病的相关性。方法：筛选和收集2012年1月-2013年12月本科收治的符合单纯呼吸衰竭（A组50例）和呼吸衰竭合并慢性肺心病（B组50例）诊断标准的患者。并选取在本院进行健康体检者（C组）的血样50份，进行血液NT-proBNP水平检测。比较三组的血液NT-proBNP水平，并对A、B两组治疗前后的NT-proBNP水平、血气指标进行比较。记录患者6个月内不良事件发生情况。结果：A、B两组治疗前、后的NT-proBNP水平均显著高于C组，差异均有统计学意义（P〈0.05）；B组在治疗前NT-proBNP水平显著高于A组，差异有统计学意义（P〈0.05）；A、B两组在治疗后的NT-proBNP水平比较无统计学意义（P〉0.05）。经过6-12个月随访，在100例呼吸衰竭患者中，因住院期间发生的病情加重需机械通气、心肺复苏或任何原因的死亡等不良事件共23次，因病情加重需再次住院有37次。发生相关不良事件的患者的NT-proBNP水平为（2849.7±394.7）pg/L显著高于未发生不良事件者的（988.7±93.1）pg/L，差异有统计学意义（P〈0.05）。结论：NT-proBNP水平与呼吸衰竭患者是否有肺心病及右心受累程度密切相关，是快速判断右心功能不全严重程度以及疗效判断的良好指标。

Correlation of NT-proBNP with Respiratory Failure and Chronic Pulmonary Heart Disease

To study the correlation of NT-proBNP with respiratory failure and chronic pulmonary heart disease.Method：100 patients who diagnosed with pure respiratory failure（the group A,50 cases）and respiratory failure with chronic pulmonary heart disease（the group B,50 cases）were selected in our hospital from January 2012 to December 2013,and healthy persons（the group C,50 cases）were detected the levels of blood NT-proBNP were selected at the same time. NT-proBNP blood levels of the three groups,and NT-proBNP levels,blood gas analysis before and after treatment were compared between the group A and B. Adverse events were recorded within 6 months.Result：Before and after treatment,the NT-proBNP levels of the group A,B were significantly higher the group C（P〈0.05）. The NT-proBNP levels of the group B were significantly higher than the group A before treatment（P〈0.05）,but there were no significant difference between the two groups about NT-proBNP levels after treatment（P〉0.05）. After 6 to 12 months of follow-up,100 cases of respiratory failure in patients,the disease occurred during hospitalization due to exacerbation requiring mechanical ventilation,cardiopulmonary resuscitation,or death from any cause other adverse events were 23 times exacerbations requiring hospitalization had 37 times again. The NT-proBNP levels of occurred related adverse events was （2849.7±394.7）pg/L,and was significantly higher than the patients with no adverse events of（988.7±93.1）pg/L（P〈0.05）. Conclusion：NT-proBNP levels in patients with respiratory failure,pulmonary heart disease and whether the degree of right ventricular involvement is closely related,is quick to judge a good indicator of the severity of right ventricular dysfunction and the effect of the judgment.