慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭患者血浆N端脑钠肽前体及心肌肌钙蛋白测定的意义

目的 探讨慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭患者血浆N端脑钠肽前体(NT-proBNP)和心肌肌钙蛋白I(cTnI)的水平及临床意义.方法 选择80例确诊为AECOPD患者,单纯AECOPD患者40例为对照组,AECOPD合并Ⅱ型呼吸衰竭组40例为研究组.用电化学发光法测定血浆NT-proBNP及cTnI,并同步进行血气分析、肺功能检查,心脏超声多普勒测定三尖瓣反流速度估测肺动脉收缩压,比较其差异.结果 研究组与对照组的NT-proBNP水平分别为(478±44)、(61±10) ng/L,sPAP水平分别为(63±15)、(26±5)mm Hg(1 mm Hg =0.133 kPa),cTnI水平分别为(0.40±0.09)、(0.06±0.01) μg/L,PaO2水平分别为(50±4)、(70±6)mm Hg.2组差异均有统计学意义(均P＜0.05).研究组血浆NT-proB-NP与肺动脉收缩压呈正相关(r=0.75,P＜0.05),与cTnI呈正相关(r=0.65,P＜0.05),与PaO2呈负相关(r=-0.73,P＜0.05).结论 血浆NT-proBNP、cTnI对指导AECOPD治疗及评价患者预后有指导意义.

Clinical significance of NT-proBNP and cardiac troponin in acute exacerbation of chronic obstructive pulmo nary disease patients

Objective To study the change and the singifiance of N-terminal pro-B natriuretic peptide (NT-proBNP) and cardiac tropnin-I( cTnI )in the acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients with respiratory failure.Methods Totolly 80 hospitalized AECOPD patients were divided into the pure AECOPD group and the AECOPD with respiratory failure group,N-terminal pro-brain and TnI was measured by using electrochem inescence law and the difference was compared finally.Results N-terminal pro-brain and TnI in the AECOPD with respiratory failure group was higher than that in the pure AECOPD group( P ＜ 0.05 ),N-terminal pro-brain levels were positively correlated with pulmonary arterial systolic pressure ( r = 0.75,P ＜ 0.05 ) and cTnI ( r =0.65,P ＜ 0.05 ),N-terminal pro-brain levels were negatively correlated with PaO2 ( r = -0.73,P ＜ 0.05 ).Conclusion Deteming the level of N-terminal pro-brain and cTnI can be helpful of judging the severity degree and prognosis in AECOPD.