CAJ | 학술논문

目的探讨血浆氨基末端B型利钠肽前体( NT-proB-NP)与低氧血症之间的关系。方法回顾性分析453例同时行NT-proBNP、血气分析及超声心动图检查的住院患者临床资料,根据氧合指数分为低氧血症组和无低氧血症组,比较两组患者血浆NT-proBNP浓度变化,并分别比较在左心室收缩功能不全、肺动脉高压、左心室收缩功能不全合并肺动脉高压及心功能正常情况下两组血浆NT-proBNP浓度的变化。将心功能正常条件下的低氧血症组患者根据氧合指数分为Ⅰ(301~400 mmHg )、Ⅱ(201~300 mmHg )、Ⅲ(≤200 mmHg)3个亚组,分析低氧程度与血浆NT-proBNP浓度的关系。结果[1]低氧血症组患者血浆NT-proBNP浓度高于无低氧血症组( P<0.01)。在左心室收缩功能不全、肺动脉高压、心功能正常3种情况下低氧血症组患者NT-proBNP浓度均高于无低氧血症组(P<0.05)。于在心功能正常条件下的低氧血症组中,Ⅲ组患者的血浆NT-proBNP水平高于Ⅰ和Ⅱ组(P<0.05)。[3]血浆NT-proBNP浓度与氧合指数呈负相关；与PaCO2不相关。结论低氧血症可能是血浆NT-proBNP浓度升高的一个独立影响因素,并且与缺氧程度呈正相关。
목적탐토혈장안기말단B형리납태전체( NT-proB-NP)여저양혈증지간적관계。방법회고성분석453례동시행NT-proBNP、혈기분석급초성심동도검사적주원환자림상자료,근거양합지수분위저양혈증조화무저양혈증조,비교량조환자혈장NT-proBNP농도변화,병분별비교재좌심실수축공능불전、폐동맥고압、좌심실수축공능불전합병폐동맥고압급심공능정상정황하량조혈장NT-proBNP농도적변화。장심공능정상조건하적저양혈증조환자근거양합지수분위Ⅰ(301~400 mmHg )、Ⅱ(201~300 mmHg )、Ⅲ(≤200 mmHg)3개아조,분석저양정도여혈장NT-proBNP농도적관계。결과[1]저양혈증조환자혈장NT-proBNP농도고우무저양혈증조( P<0.01)。재좌심실수축공능불전、폐동맥고압、심공능정상3충정황하저양혈증조환자NT-proBNP농도균고우무저양혈증조(P<0.05)。우재심공능정상조건하적저양혈증조중,Ⅲ조환자적혈장NT-proBNP수평고우Ⅰ화Ⅱ조(P<0.05)。[3]혈장NT-proBNP농도여양합지수정부상관；여PaCO2불상관。결론저양혈증가능시혈장NT-proBNP농도승고적일개독립영향인소,병차여결양정도정정상관。
Objective To explore the relationship between NT-proBNP and hypoxemia. Methods 453 patients who accepted examinations of plasma NT-proBNP,blood gas analysis and echocardiography were retrospectively in-vestigated and were divided into hypoxic and normoxic groups according to oxygeneration index. The concentrations of serum NT-proBNP were compared in the two groups,and also on situations including left ventricular systolic dys-function,pulmonary artery hypertension,left ventricular systolic dysfunction with pulmonary artery hypertension and normal cardiac function. Then the hypoxic patients with normal cardiac function were classified into three sub-groups:Ⅰ( oxygeneration index:301~400 mmHg) ,II( oxygeneration index:201~300 mmHg) ,Ⅲ( oxygeneration index≤200 mmHg) to detect the relationship between NT-proBNP and the degree of hypoxia. Results ① In hy-poxic group,the plasma NT-proBNP levels were higher than patients in normoxic group(P<0.01). NT-proBNP lev-els were also higher in hypoxic group in patients with left ventricular systolic dysfunction or pulmonary artery hyper-tension or normal cardiac function(P<0.05).②NT-proBNP levels were higher in sub-groupⅢthanⅠandII(P<0.05) in hypoxic patients without heart dysfunction.③ The correlation analysis suggested that NT-proBNP was negatively correlated with oxygeneration index and there was no correlation between NT-proBNP and PaCO2 . Con-clusion Hypoxemia may be an independent factor which influences plasma NT-proBNP levels. NT-proBNP posi-tively correlates with the degree of hypoxia.