血浆脑钠肽在慢性阻塞性肺病的意义分析.doc

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1、血浆脑钠肽在慢性阻塞性肺病的意义分析摘要背景：鉴于预后极差，对慢性阻塞性肺病(COPD)患者潜在PH或慢性肺源性心脏病(chronicpulmonaryheartdisease)其早期确诊极为重耍。目的：在检测COPD病患(于症状及体征上排除肺动脉高压及chronicpulmonaryheartdisease)其血浆脑钠肽(BNP)层次后，探究血浆BNP于COPD预后预测里起到什么功能。方法：检测60位COPD患者、10位哮喘患者、30位健康人员的血浆BNP水平，同时检测超声心动图、动脉血气分析、肺功能。随访3年，对比COPD病患中高

2、血浆BNP层次和低层次其死亡率和恶化状况。结果：COPD组的血浆BNP水平(41±6.6pg/ml)显著比健康组(14.8±2.7pg/ml)(p<0.0001)和哮喘组(17.4±4.5pg/ml)(p<0.05)的高。血浆BNP层次和肺功能或血氧层次没冇显著联系，但和左室射血分数(r=041,p二0.0197)及肺动脉收缩压(r=0.5,p=0.004)有显著关联。在COPD组测得血浆BNP程度高者出现急性加剧期显然减少了(p<0.05)ochronicpulmonaryheartdisease急性加剧时间其血浆BNP层次(79.

3、9±16.2pg/ml)比稳定期(41.2±8.7pg/ml)显著升高(p=0.004)o结论：血浆BNP水平作为一项无创的生物标志物可用以筛查潜在的肺动脉高压及左心室功能障碍，也可用于稳定期慢性阻塞性肺病发生急性加重的预测。关键词：慢性阻塞性肺病，脑钠肽，肺动脉高压，慢性肺源性心脏病。AbstractBackground:Earlydiagnosisofchronicobstructivepulmonarydisease(COPD)withlatentpulmonaryhypertension(PH)andcorpulmonalei

4、simportantbecausetheprognosisofthisconditionispoor.Objective:Toinvestigatetheutilityofbrainnatriureticpeptide(BNP)forprognosticationofCOPD,plasmaBNPwasmeasuredinpatientswithCOPDwithoutsymptomsorphysicalfindingsofPHorcorpulmonale.Methods:PlasmaBNPwasmeasuredin60patientsw

5、ithCOPD,10asthmatics,and30healthysubjects.Echocardiography,arterialbloodgasanalysis,andspirometrywerealsoperformed.MortalityandexacerbationwerecomparedbetweenCOPDpatientswithhighandlowplasmaBNPlevelsovera3-yearfollow-upperiod.Results:PlasmaBNP(mean±SEM,pg/mL)inCOPDpatie

6、nts(41.0±6.6)wassignificantlyhigherthaninnormalsubjects(14.8±2.7)andasthmatics(17.4±4.5)(p<0.0001andp<0.05,respectively).NosignificantcorrelationswereobservedbetweenplasmaBNPlevelandpulmonaryfunctionorhypoxia.Therewas,how-ever;asign讦icantcorrelationbetweenplasmaBN

7、Pleveland%ejectionfraction(r=-0.41,p=0.0197)andpulmonaryarterysystolicpressure(r=0.5?p=0.004).TheperioduntilinitialCOPDexacerbationinsubjectswithahighplasmaBNPlevelwassign讦icantlyshorter(p<0.05).PlasmaBNPlevelduringexacerbations(79.9±16.2)wasalsosignificantlyhigherth

8、anduringstabledisease(41.2±8.7)(p=0.004).ConelusionWesuggestthatplasmaBNPisanon・invasivebiomarkerthatcanbeused