论文部分内容阅读
目的探讨间质性肺疾病患者血清脑钠肽与心肺功能的相关性及对预后的评估作用。方法回顾性选取2010年2月至2013年4月入住厦门市中医院的间质性肺疾病患者的临床资料。采用Pearson和Spearman统计学方法分析患者脑钠肽与心脏多普勒、肺功能各项检查指标的相关性,并将患者分为存活组和死亡组、合并肺动脉高压组与未合并肺动脉高压组,对各项临床指标进行预后价值比较。结果共纳入38例间质性肺疾病患者,其血清B型脑钠肽水平与心脏多普勒右心功能的各项指标、肺动脉收缩压、右心房内径、右心室内径、右心室舒张末期内径均有较好的相关性(P<0.05),而与左心功能的各项指标无显著相关性(P>0.05);与一氧化碳弥散量占预计值百分比(DLCO%pred)有显著相关性(P<0.05)。死亡组和肺动脉高压组患者的脑钠肽水平,以及除右心房内径外其余右心功能指标均显著高于存活组和无肺动脉压组(P<0.05),而前两组DLCO%pred显著低于后两组(P<0.05)。结论间质性肺疾病患者血清脑钠肽水平能较好地反映其右心功能情况,提示间质性肺疾病患者有不同程度的肺血管受累,导致肺血管阻力的增加。而高水平的脑钠肽水平提示患者预后差,病死率高。
Objective To investigate the correlation between serum brain natriuretic peptide and cardiopulmonary function in patients with interstitial lung disease and its prognostic value. Methods The clinical data of patients with interstitial lung disease admitted to Xiamen Hospital of Traditional Chinese Medicine from February 2010 to April 2013 were retrospectively selected. The Pearson and Spearman statistical methods were used to analyze the correlation between brain natriuretic peptide and cardiac Doppler and pulmonary function indexes. The patients were divided into survivor group and death group with pulmonary hypertension group and non-pulmonary hypertension group, Prognostic value of the clinical indicators of comparison. Results A total of 38 patients with interstitial lung disease were enrolled in this study. Serum B-type natriuretic peptide and various parameters of Doppler right ventricular function, pulmonary artery systolic pressure, right atrium diameter, right ventricular diameter, right ventricular end-diastolic diameter (P <0.05), but not with the indexes of left ventricular function (P> 0.05), but also significantly correlated with the percentage of diffused carbon monoxide (DLCO% pred) P <0.05). Brain natriuretic peptide levels in patients with death and pulmonary hypertension were significantly higher than those in surviving and non-pulmonary arterial pressure groups (P <0.05), while right ventricular function indexes other than right atrial diameter were significantly lower In the latter two groups (P <0.05). Conclusion Serum brain natriuretic peptide level in patients with interstitial lung disease can better reflect the right ventricular function, suggesting that patients with interstitial lung disease have different degrees of pulmonary vascular involvement, leading to increased pulmonary vascular resistance. The high level of brain natriuretic peptide levels suggest that patients with poor prognosis, high mortality.