CAJ | 학술논문

目的分析血浆脑钠肽（BNP）水平对老年慢性阻塞性肺疾病（COPD）患者肺动脉高压（PH）及预后的评估价值。方法选取100例老年COPD患者作为病例组，根据其疾病类型将其分为AECOPD组（ A组，29例）、AECOPD合并PH组（ B组，44例），COPD稳定期组（ C组，共27例），根据B组患者的肺动脉收缩压（PASP）水平将其为轻度组（35 mm Hg＜PASP≤45 mm Hg，14例）、中度组（45 mm Hg＜PASP磠55 mm Hg，15例）和重度（ PASP＞55 mm Hg，15例）三个亚组。选取40例健康老年人作为对照组。对所有纳入研究对象的血浆BNP水平、动脉血氧分压（ PaO2）水平进行分析；对B组患者的生存时间进行随访。结果 C组、A组、B组患者的血浆BNP水平依次升高且均显著高于对照组（q＝4．725～6．127，P＜0．05）；B组患者的PaO2水平显著低于A组且均显著低于C组或对照组（q＝3．155～3．751，P＜0．05）；随着PH病情的加重，患者的血浆BNP水平上升（q＝5．623～8．435，P＜0．05），重度组患者的PaO2水平显著低于轻度组或中度组（q＝3．254、3．538，P＜0．05），患者的血浆BNP水平与PaO2水平呈负相关（r＝－0．362，P＜0．05）而与PASP呈正相关（ r＝0．772，P＜0．05）。结论老年AECOPD合并PH患者血浆BNP水平显著升高，其升高幅度与病情严重程度具有相关性，但不能用于预测患者的预后情况。
목적분석혈장뇌납태（BNP）수평대노년만성조새성폐질병（COPD）환자폐동맥고압（PH）급예후적평고개치。방법선취100례노년COPD환자작위병례조，근거기질병류형장기분위AECOPD조（ A조，29례）、AECOPD합병PH조（ B조，44례），COPD은정기조（ C조，공27례），근거B조환자적폐동맥수축압（PASP）수평장기위경도조（35 mm Hg＜PASP≤45 mm Hg，14례）、중도조（45 mm Hg＜PASP노55 mm Hg，15례）화중도（ PASP＞55 mm Hg，15례）삼개아조。선취40례건강노년인작위대조조。대소유납입연구대상적혈장BNP수평、동맥혈양분압（ PaO2）수평진행분석；대B조환자적생존시간진행수방。결과 C조、A조、B조환자적혈장BNP수평의차승고차균현저고우대조조（q＝4．725～6．127，P＜0．05）；B조환자적PaO2수평현저저우A조차균현저저우C조혹대조조（q＝3．155～3．751，P＜0．05）；수착PH병정적가중，환자적혈장BNP수평상승（q＝5．623～8．435，P＜0．05），중도조환자적PaO2수평현저저우경도조혹중도조（q＝3．254、3．538，P＜0．05），환자적혈장BNP수평여PaO2수평정부상관（r＝－0．362，P＜0．05）이여PASP정정상관（ r＝0．772，P＜0．05）。결론노년AECOPD합병PH환자혈장BNP수평현저승고，기승고폭도여병정엄중정도구유상관성，단불능용우예측환자적예후정황。
Objective To analyze the significance of plasma brain natriuretic peptide ( BNP) level in the as-sessment of prognosis for the elderly pulmonary hypertension( PH) patients with chronic obstructive pulmonary disease (COPD).Methods 100casesofelderlypatientswithCOPDwereselectedanddividedintotheAECOPDgroup ( group A,29 cases) ,the AECOPD complicated with PH group ( group B,44 cases) ,the stable phase of COPD group ( group C,27 cases) according to the type of the diseases.According to the levels of pulmonary artery systolic pressure ( PASP) ,the patients in group B were divided into three subgroups:the mild group (35 mm Hg<PASP≤45 mm Hg, 14 cases),the moderate group (45 mm Hg<PASP≤55 mm Hg,15 cases) and the severe group (PASP>55 mm Hg,15 cases) .40 cases of healthy elderly people were selected as the control group.The level of plasma BNP,the ar-terial oxygen partial pressure ( PaO2 ) of all included subjects were tested and compared.The survival time of the pa-tients in group B was followed up and compared.Results The plasma BNP levels of the patients in group C,group A and group B were increased gradually and were all higher than that in the control group ( q=5.367-18.306,P<0.05);The arterial blood PaO2 level of the patients in group B was lower than that in group A,and both were signifi-cantly lower than that in group C or the control group (q=3.155-3.751, P <0.05);the plasma BNP level of the patients increased gradually with the deterioration of the PH,(q =6.358-10.391,P <0.05).The arterial blood PaO2 level of the patients in the severe group was significantly lower than that in the mild group and the moderate group (q =3.254,3.538,P<0.05).The plasma BNP level of patients was negatively correlated with the arterial blood PaO2 level (r=-0.406,P<0.05) and positively correlated with PASP ( r=0.862,P<0.05) of the pa-tients.Conclusions The increased plasma BNP amplitude,with is associated with the severity of the diseases,could be used as an auxiliary index in the evaluation of the patients’ disease progress.However,there is an absence of cor-relation between the level and the prognosis of the patients,and the index cannot be used to predict the prognosis of the patients.