血浆脑钠肽与肺动脉高压血流动力学类型的关系

目的探讨血浆脑钠肽(BNP)在鉴别肺动脉高压血流动力学类型中的意义。方法对164例肺动脉高压患者的临床资料进行回顾性分析,其中毛细血管前肺动脉高压右心功能正常患者62例(A组);毛细血管后肺动脉高压右心功能正常患者58例(B组);毛细血管前肺动脉高压合并右心功能不全患者44例(C组)。采用单克隆非均相免疫法测定全血BNP浓度。结果 3组患者BNP分别为87.5(50.0～157.0)、472.5(324.0～652.0)和541.5(364.5～729.5)ng.L-1,3组间BNP比较差异有统计学意义(P<0.05)。经两两比较,A组BNP浓度低于B组和C组,差异均有统计学意义(P<0.05),B组与C组间比较差异无统计学意义(P>0.05)。结论血浆BNP测定有助于判定肺动脉高压患者是否合并心功能不全,但不能鉴别心功能不全类型。

Relationship between brain natriuretic peptide and hemodynamics type in patients with pulmonary arterial hypertension

Objective To explore the significance of plasma brain natriuretic peptide(BNP) levels in differentiated the haemodynamics type of pulmonary arterial hypertension patients. Methods One hundred and sixty-four patients were included and their data were retrospectively analyzed.All patients were divided into three groups.Group A contained 62 patients who had pre-capillary pulmonary hypertension without right heart insufficiency.Group B contained 58 patients who had post-capillary pulmonary hypertension without right heart insufficiency.Group C contained 44 patients who had pre-capillary pulmonary hypertension companied with right heart insufficiency.The concentration of BNP was detected by monoclonal heterogeneous immunoassay. Results The plasma BNP levels among three groups were 87.5(50.0-157.0),472.5(324.0-652.0)and 541.5(364.5-729.5) ng·L-1 respectively,and there were statistic differences in three groups(P<0.05).The plasma BNP levels in group A were significantly lower than in group B and group C(P<0.05).There was no statistic difference of plasma BNP level between group B and group C(P>0.05). Conclusion The measurement of plasma BNP contributes to the judgement of pulmonary artery hypertension patients with or without cardia insufficiency.However,it fails to distinguish the type of cardia insufficiency.