高敏肌钙蛋白及氨基末端脑钠肽前体在老年肺心病患者早期诊断及预后评估的临床意义

目的：探讨高敏肌钙蛋白（hs-TnT）及氨基末端脑钠肽前体（NT-proBNP）对老年肺心病早期诊断以及预后临床价值。方法：选60例老年肺心病患者为观察组,分别按肺动脉高压分成轻中重度各20例,慢性阻塞性肺疾病20例作为对照组,测定各组急性加重期和缓解期的NT-proBNP及hs-TnT,比较各组间两指标的差异及缓解期6个月的再入院率及死亡率。结果：在急性加重期,观察组患者hs-TnT及NT-proBNP的含量明显高于对照组患者,结果具有明显性差异（P〈0.05）,且其水平在轻、中、重度肺动脉高于组间差异有统计学意义,即使在缓解期观察组患者hs-TnT及NT-proBNP的含量仍高于对照组,其6个月的再入院率及死亡率明显高于对照组。结论：将hs-TnT及NT-proBNP作为CCP的早期临床诊断以及预后指标,可以明显提高CCP诊断的灵敏性,作为判断CCP严重程度的一项指标,作为长期预后的危险因子。

The Early Diagnosis and Prognosis Evaluation of Elderly Pulmonary Heart Disease Patients by High-sensitivity Cardiac Troponin and Amino Terminal Brain Natriuretic Peptide Precursor

Objective： To study the early diagnosis and prognosis evaluation clinical significance of elderly pulmonary heart disease patients by high-sensitivity cardiactroponin and amino terminal brain natriuretic peptide precursor. Method： 60 elderly pulmonary heart disease patients were selected as the observation group,The patients with chronic obstructive pulmonary disease were divided into mild moderate and severe according to the pulmonary arterial hypertension 20 cases patients were selected as the control group,the NT-proBNP and hs-TnT were measured at the acute exacerbation and remission,NT-proBNP and hs-TnT and the readmission rate and mortality rate after six months were compared. Result： In acute aggravating period,NT-proBNP and hs-TnT level of the observation group patients was significantly higher than that of the control group（ P〈0.05）,There was statistically significant difference among light,medium and severe pulmonary artery pressure,even in remission,NT-proBNP and hs-TnT level of the observation group patients was still higher than that of the control group,the readmission rate and mortality after six months was significantly higher than that of the control group. Conclusion： High-sensitivity cardiactroponin and amino terminal brain natriuretic peptide precursor can obviously increase the elderly pulmonary heart disease diagnostic sensitivity,it was an indicator of the severity of CCP as long-term prognostic risk factors.