摘要
目的检测慢性肺源性心脏病(肺心病)急性加重期血浆N-端脑钠肽前体(NT-proBNP)含量,探讨其临床意义。观察冻干重组人脑利钠肽(rhBNP)治疗肺心病急性加重期的临床疗效。方法选择我科2019年1月至2020年12月收治的肺心病急性加重期患者184例,同期收住我科的其他呼吸系统疾病患者184例作为对照组,测定两组NT-proBNP含量并进行比较。肺心病组NT-proBNP含量<1000 pg/mL的54例,(1000~2000)pg/mL之间40例,>2000 pg/mL 90例,比较不同含量对应心功能分级情况。含量>2000 pg/mL患者随机分为药物组和对照组,两组在常规氧疗、抗感染、平喘、祛痰等治疗基础上,药物组加用rhBNP,比较两组临床疗效。同时,再测定药物组患者治疗后NT-proBNP含量,比较治疗前后变化。结果肺心病组和对照组的NT-proBNP浓度分别为(2068±975)pg/mL和(731±329)pg/mL,组间比较差异有统计学意义(P<0.05);肺心病组NT-proBNP含量<1000 pg/mL心功能为Ⅱ级,(1000~2000)pg/mL心功能为Ⅲ级,>2000 pg/mL心功能为Ⅳ级;药物组和对照组总有效率分别为97.8%和82.2%,组间比较差异有统计学意义(P<0.05);药物组治疗前后NT-proBNP含量分别为(3547±1486)pg/mL和(625±413)pg/mL,组内比较差异有统计学意义(P<0.01)。结论测定NT-proBNP含量有助于早期诊断肺心病心力衰竭和评估心力衰竭严重程度,为调整治疗方案提供科学依据。同时对肺心病心力衰竭疗效评估及预后判断有重要意义。rhBNP治疗肺心病急性加重期心力衰竭疗效确切,不良反应少,值得临床推广应用。
Objective To detect the level of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP)during the acute exacerbation of chronic pulmonary heart disease(cor pulmonale),explore its clinical significance,and observe the clinical efficacy of freeze-dried recombinant human brain natriuretic peptide(rhBNP)in the treatment of acute exacerbation of cor pulmonale.Methods A total of 184 patients with acute exacerbation of cor pulmonale admitted to our department from January 2019 to December 2020 were selected.184 patients with other respiratory diseases in our department were enrolled as the control group during the same period.The levels of NT-proBNP in the two groups were measured and compared.In the cor pulmonale group,there were 54 cases of NT-proBNP level<1000 pg/mL,40 cases of NT-proBNP level between 1000 pg/mL and 2000 pg/mL,and 90 cases of the level>2000 pg/mL,and the classification of heart function corresponding to the different levels were compared.Patients with level>2000 pg/mL were randomly divided into the drug group and the control group.And the clinical efficacy of these two groups was compared on the basis of the aspects of conventional oxygen therapy,anti-infection,asthma,expectorant action(add rhBNP to the drug group).At the same time,the level of NT-proBNP in drug group patients after treatment was measured and the change before and after treatment was compared.Results NT-proBNP concentrations in the cor pulmonale and control groups were(2068±975)pg/mL and(731±329)pg/mL,respectively,with statistically significant differences(P<0.05).In the cor pulmonale group,the corresponding heart function classification of NT-proBNP level<1000 pg/mL was gradeⅡ;the corresponding heart function classification of NT-proBNP level between 1000-2000 pg/mL was gradeⅢand the corresponding heart function classification of>2000 pg/mL was gradeⅣ.The total response rates in drug and control groups were 97.8%and 82.2%,with statistically significant differences(P<0.05).NT-proBNP levels in the drug group before and after treatment were(3547±1486)pg/mL and(625±413)pg/mL,respectively,with statistically significant differences(P<0.01).Conclusion The determination of NT-proBNP levels can facilitate early diagnosis and assessment of heart failure severity in cor pulmonale,providing a scientific basis for treatment protocol adjustment.At the same time,it is important to evaluate the efficacy and prognosis of heart failure in cor pulmonale.The efficacy of rhBNP in the treatment of heart failure during the acute exacerbation of cor pulmonale is obvious,with few adverse reactions.It is worthy of clinical application.
作者
林涛
吴佳
盛俊清
林建伟
伊雅丽
程瑾
魏桂莲
康耀文
LIN Tao;WU Jia;SHENG Junqing;LIN Jianwei;YI Yali;CHENG Jin;WEI Guilian;KANG Yaowen(Department of Respiratory and Critical Care Medicine,the Fifth People′s Hospital of Datong in Shanxi Province,Datong 037009,China)
出处
《中国现代医生》
2021年第32期11-13,17,共4页
China Modern Doctor
基金
山西省卫生计生委科研项目计划(201602020)
山西省大同市重点研发计划项目(2018093)。
关键词
肺心病
N-端脑钠肽前体
重组人脑利钠肽
治疗效果
Cor pulmonale
N-terminal pro-brain natriuretic peptide
Recombinant human brain natriuretic peptide
Therapeutic effect
