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1、血漿腦鈉肽在慢性阻塞性肺病的意義分析摘要背景：鑒于預后極差，對慢性阻塞性肺病(COPD)患者潛在PH或慢性肺源性心臟病(chronicpulmonaryheartdisease)其早期確診極為重耍。目的：在檢測COPD病患(于癥狀及體征上排除肺動脈高壓及chronicpulmonaryheartdisease)其血漿腦鈉肽(BNP)層次后，探究血漿BNP于COPD預后預測里起到什么功能。方法：檢測60位COPD患者、10位哮喘患者、30位健康人員的血漿BNP水平，同時檢測超聲心動圖、動脈血氣分析、肺功能。隨訪3年，對比COPD病患中高
2、血漿BNP層次和低層次其死亡率和惡化狀況。結果：COPD組的血漿BNP水平(41±6.6pg/ml)顯著比健康組(14.8±2.7pg/ml)(p<0.0001)和哮喘組(17.4±4.5pg/ml)(p<0.05)的高。血漿BNP層次和肺功能或血氧層次沒冇顯著聯系，但和左室射血分數(r=041,p二0.0197)及肺動脈收縮壓(r=0.5,p=0.004)有顯著關聯。在COPD組測得血漿BNP程度高者出現急性加劇期顯然減少了(p<0.05)ochronicpulmonaryheartdisease急性加劇時間其血漿BNP層次(79.
3、9±16.2pg/ml)比穩(wěn)定期(41.2±8.7pg/ml)顯著升高(p=0.004)o結論：血漿BNP水平作為一項無創(chuàng)的生物標志物可用以篩查潛在的肺動脈高壓及左心室功能障礙，也可用于穩(wěn)定期慢性阻塞性肺病發(fā)生急性加重的預測。關鍵詞：慢性阻塞性肺病，腦鈉肽，肺動脈高壓，慢性肺源性心臟病。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訐icantcorrelationbetweenplasmaBN
7、Pleveland%ejectionfraction(r=-0.41,p=0.0197)andpulmonaryarterysystolicpressure(r=0.5?p=0.004).TheperioduntilinitialCOPDexacerbationinsubjectswithahighplasmaBNPlevelwassign訐icantlyshorter(p<0.05).PlasmaBNPlevelduringexacerbations(79.9±16.2)wasalsosignificantlyhigherth
8、anduringstabledisease(41.2±8.7)(p=0.004).ConelusionWesuggestthatplasmaBNPisanon?invasivebiomarkerthatcanbeused
