血清脑钠肽水平检测在慢性阻塞性肺疾病合并慢性肺源性心脏病诊治中的价值

目的 检测血清脑钠肽（BNP）在慢性阻塞性肺疾病（COPD）合并慢性肺源性心脏病代偿期、失代偿期治疗前后的变化,探讨其临床应用价值.方法 收集沛县人民医院2011年6月至2012年12月呼吸科收治的COPD急性加重期、COPD合并慢性肺源性心脏病代偿期、失代偿期各50例患者,采用电化学发光法检测其血清BNP水平.结果 COPD急性加重期组BNP稍高于正常值,而COPD合并慢性肺源性心脏病代偿期、失代偿期血清BNP明显升高,与COPD急性加重期比较差异有统计学意义（P〈0.05）,且慢性肺源性心脏病治疗后临床症状好转,血清BNP水平随之下降.结论 血清BNP水平的检测可作为COPD合并肺源性心脏病的早期诊断、严重程度的判断及治疗效果评价的指标.

Diagnosis and treatment value of serum brain natriuretic peptide levels of detection in patients with chronic obstructive pulmonary disease combined with chronic pulmonary heart disease

Objective To detect the changes of serum brain natriuretic peptide（BNP） levels in chornic obstructive pulmonary disease（COPD） combined with compensated and decompensated chornic pulmonary heart disease before and after treatment, and to investigate the clinical value. Methods Fifty patients with acute exacerbation of COPD, 50 patients with COPD combined with compensated chornic pulmonary heart disease and 50 patients with COPD combined with decompensated chornic pulmonary heart disease were selected. The BNP levels were measured by ECLIA. Results The BNP level in patients with acute exacerbation of COPD was slightly higher than the normal values, while the BNP level in patients with COPD combined with compensated and decompensated was significantly increased. The difference was significant compared with acute exacerbation of COPD（ P 〈 0.05 ）. The clinical symptoms improved and the BNP level decreased after the treatment of chornic pulmonary heart disease. Conclusion The detection of the BNP level can be used as the early diagnosis, judgment of severe degree, and the evaluation of treatment of COPD complicated with pulmonary heart disease.