夜间阵发性呼吸困难患者N末端B型钠尿肽原的变化及其影响因素

摘要

Objective To investigate the concentration of N terminal B type natriuretic peptide (NT-proBNP)in paroxysmal nocturnal dyspnea patients with different causes and to analyze the related factors.Methods A total of 227 cases of hospitalized patients were collected,145 cases of coronary heart disease,14 cases of rheumatic heart disease,14 cases of hyperthyroid heart disease,23 cases of chronic obstructive pulmonary disease,18 cases of uremia,13 cases of anxiety,NT-proBNP levels were measured.Results The NT-proBNP level of uremia group was higher than the coro-nary heart disease group(24113.4± 14178.41 pg/ml vs7051.90± 7667.19 pg/ml),The NT-proBNP levels of hyper-thyroid heart disease group(1048.40± 707.29 pg/ml)and rheumatic heart disease group(1172.82 ± 867.97 pg/ml) were lower than coronary heart disease group,but higher than chronic obstructive pulmonary disease group (235.65± 247.05 pg/ml),the NT-proBNP level of anxiety group (37.34 ± 10.75 pg/ml)was lower than other groups,The differences were significant (P < 0.05),there was no significant difference of NT-proBNP levels between rheumatic heart disease group and hyperthyroid heart disease group (P > 0.05).There was negative correlation between NT-proBNP and hemoglobin in coronary heart disease group,there were positive correlations among levels of NT-proBNP and creatinine,creatine kinase,creatine kinase MB isoenzyme,myoglobin,troponin I and neutrophil cell percentage(P <0.05).Conclusion There were different causes of paroxysmal nocturnal dyspnea,NT-proBNP detection play a certain role in differential diagnosis,which level was affected by many factors.%目的：探讨夜间阵发性呼吸困难患者 N 末端 B 型钠尿肽原（NT-proBNP）的变化及其影响因素。方法住院患者227例，冠状动脉性心脏病145例，风湿性心脏病14例，甲亢性心脏病14例，慢性阻塞肺疾病23例，尿毒症18例，焦虑状态13例，分别检测 NT-proBNP 水平。结果尿毒症组 NT-proBNP 水平（24113．4±14178．41pg／ml）高于冠状动脉性心脏病组（7051．90±7667．19 pg／ml），风湿性心脏病组（1172．82±867．97 pg／ml）及甲亢性心脏病组（1048．40±707．29 pg／ml）NT-proBNP 水平低于冠状动脉性心脏病组而高于慢性阻塞肺疾病组（235．65±247．05 pg／ml），焦虑状态组（37．34±10．75 pg／ml）低于其余各组，差异具有统计学意义（P ＜0．05），风湿性心脏病组与甲亢性心脏病组 NT-proBNP 水平比较差异无统计学意义（P ＞0．05）。冠状动脉性心脏病组血红蛋白浓度与 NT-proBNP 水平呈负相关，肌酐、肌酸激酶、肌酸激酶同工酶、肌红蛋白、肌钙蛋白 I 及中性粒细胞比例等成正相关（P ＜0．05），结论夜间阵发性呼吸困难可由多种疾病引起，测定 NT-proBNP 水平有助于鉴别诊断，同时其水平受多种因素影响。