急性一氧化碳中毒血浆NT-proBNP的变化及其与LVEF之间的关系

目的：探讨血浆N末端B型脑钠肽原（NT-proBNP）在急性一氧化碳中毒（ACOP）患者心功能评价中的临床意义。方法回顾性观察2010年10月～2014年2月在我科住院的急性一氧化碳中毒患者68例，按照中毒程度分为轻、中、重3组。取同一时期30例健康体检者作为对照。患者入院后2h内抽取静脉血测定血浆NT-proBNP水平，24h内超声心动图检测左室射血分数（LVEF）。结果和对照组比较，ACOP轻、中、重度组血浆NT-proBNP水平升高，LVEF则下降，与对照组比较有显著性差异（P〈0.01）。轻、中、重度ACOP 3组NT-proBNP相互比较，重度组高于中度及轻度组，中度组高于轻度组，有显著性差异（P〈0.01），而LVEF则呈相反变化趋势，NT-proBNP和LVEF具有负相关。结论 ACOP患者血浆NT-proBNP升高，LVEF则下降，且NT-proBNP随中毒程度加深而显著升高，与左室射血功能密切相关，可作为ACOP的常规检查，对ACOP后心功能评估有着重要意义。

The relationship between plasma NT-proBNP and LVEF in patients with acute carbon monoxide poisoning

Objective To investigate the clinical significance of N terminal B type natriuretic peptide （NT-proBNP）in evaluating of heart function in patients with acute carbon monoxide poisoning （ACOP）. Methods Selected 68 cases of acute carbon monoxide poisoning patient from Oct 2010 to Feb 2014 and divided into three groups （mild,moderate and severe） in ac-cordance with the degree of intoxication. Selected 30 healthy examination cases during the same period as the control group. De-tected blood plasma NT-proBNP level and left ventricular ejection fraction （LVEF） by echocardiogram. Results Compared with control group NT-proBNP increased significantly in mild,moderate and severe group （P〈0.01）. NT-proBNP of severe group was significantly higher than mild and moderate group （P〈0.05）, that of moderate group was significantly higher than mild group （P〈0.05）. But compared with NT-proBNP LVEF had adverse change trend,and LVEF had negetive correlation with NT-proB-NP. Conclusion NT-proBNP increases significantly when the poisoning of carbon monoxide deepens. That can be used as regular test for ACOP for evaluating heart function and should be to popularized.