Abstract：Objective:To investigate the clinical significance of plasma brain natriuretic peptide (BNP) level in elderly patients with chronic obstructive pulmonary disease (COPD) with pulmonary hypertension (PAH). Methods:75 aged COPD patients and 30 healthy peers who were enrolled in the hospital during the period of ~2017 in January 2017 were selected as the COPD group and the control group. According to the detection level of pulmonary artery systolic pressure (PASP), 39 cases of group COPD were not PAH (PASP < 35mmHg), and PAH group (PASP > 35mmHg) were divided into 14 cases of mild group (35mmHg < PASP < 50mmHg), 15 cases of moderate group and 10 cases of severe group. The BNP expression characteristics of COPD in the above groups were observed, and the correlation between BNP and PASP levels was analyzed. Results: The blood BNP and PASP levels in group COPD were higher than those in the control group, and the difference was statistically significant (P<0.05). The level of BNP and PASP in COPD combined with PAH group was higher than that in the non PAH group, and the difference was statistically significant (P<0.05). Linear correlation analysis and partial correlation analysis excluded gender and age factors, and there was a significant positive correlation between BNP and PASP levels (P<0.05). Conclusion: The blood BNP of the elderly COPD patients showed an abnormal rising state, and the expression was more obvious with the combination of PAH; the blood BNP and PASP levels were significantly positive correlation, which was of important guiding significance for the clinical assessment of the risk of PAH and the degree of the disease.
[1] Bogaard H J.Hypoxic pulmonary vasoconstriction in COPD-associated pulmonary hypertension:beenthere,done that[J].European Respiratory Journal,2017,50(1):1701191. [2] Jacob J,TostJ,et al.Impact of chronic obstructive pulmonary disease on clinical course after an episode of acute heart failure.EAHFE-COPD study[J].International Journal of Cardiology,2017,12(3):227:450. [3] 赵明丽,王玉忠,张露露.COPD合并肺心病患者血清hs-CRP、BNP的含量及临床意义[J].中国实验诊断学,2016,20(10):1670~1672. [4] Omar H R,GuglinM.Acute systolic heart failure with normal admission BNP:clinicalfeatures and outcomes[J].International Journal of Cardiology,2017,23(6):324~329. [5] 蔡柏蔷.慢性阻塞性肺疾病诊断、处理和预防全球策略(2017 GOLD报告)解读[J].国际呼吸杂志,2017,37(1):6~17. [6] 杨媛华,马瑞晓,庞文翼,等.ESC/ERS《肺动脉高压诊断和治疗指南》解读之治疗策略[J].中华医学杂志,2016,96(22):1793~1795. [7] Min K B,Park H J,Kim H J,et al.Asthma-COPD overlap syndrome shows favorable prognosis compared to pure COPD in Korean COPD cohort[J].Ers International Congress,2017,A4011. [8] Kamenskaya O,Klinkova A,Loginova I,et al.Factors affecting the quality of life before and after surgery in patients with chronic thromboembolic pulmonary hypertension[J].Quality of Life Research,2017,27(7):1~8. [9] 魏俊,孙军,陈学东,等.慢性阻塞性肺疾病患者肺动脉高压与血浆NT-proBNP的相关性[J].河北医学,2017,23(7):1057~1060. [10] FlorentinJ,DuttaP.Origin and production of inflammatory perivascular macrophages in pulmonary hypertension[J].Cytokine,2017,16(9):100. [11] 郁昊达,殷波,范晓东,等.BNP以及hs-CRP对COPD合并肺动脉高压诊断的临床价值分析[J].贵州医药,2016,40(3):301~302. [12] Calzetta L,Orlandi A,Page C,et al.Brain natriuretic peptide:Much more than a biomarker.[J].International Journal of Cardiology,2016,22(12):1031~1038. [13] KonigK,Guy K J,WalshG,et al.Association of BNP,NTproBNP,and early postnatal pulmonary hypertension in very preterm infants.[J].Pediatric Pulmonology,2016,51(8):820~824. [14] Plichart M,Jourdain P,et al.Brain natriuretic peptide usefulness in very elderly dyspnoeicpatients:the BED study[J].European Journal of Heart Failure,2017,19(4).25~27. [15] 赵明丽,王玉忠,张露露.COPD合并肺心病患者血清hs-CRP、BNP的含量及临床意义[J].中国实验诊断学,2016,20(10):1670~1672. [16] 张忠华,徐东波,邬波.慢性阻塞性肺疾病急性加重期并发肺动脉高压患者血浆BNP水平的变化[J].宁夏医科大学学报,2017,39(7):837~839. [17] Frantz R P,Farber H W,Badesch D B,et al.Baseline and serial brain natriuretic peptide level predicts 5-year overall survival in patients with pulmonary arterial hypertension:data from the REVEAL registry.[J].Chest,2018.2(5):3~4. [18] 陈比特,陈志斌,陈成,等.血浆脑钠肽水平对老年慢性阻塞性肺疾病患者肺动脉高压及预后的评估价值[J].中国临床保健杂志,2015,15(5):472~475.
2018, Vol. 24 
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