COPD伴肺心病患者血浆脑钠素水平及其临床诊断价值

摘要

Objective To investigate the plasma BNP level in patients with chronic obstructie pulmonary disease ( COPD ) and patients with COPD complicated with cor pulmonale ( CP ). Methods 94 cases were divived into CP group ( 31 cases ), COPD group ( 30 cases ) and normal control group ( 33 cases ). Plasma BNP values were detected with quantitative method in each group,and the ROC curves were made in COPD and CP group. Results The plasma BNP level of CP group were higher than that of COPD group and control group ( both P ＜ 0.05 ). There was no significantly difference in plasma BNP level between COPD group and control group ( P ＞ 0.05 ). According to the analysis of the ROC curve of CP, while the cut off value of BNP was 61.5pg/ml, the sensitivity was 100％ and the specificity was 97％ respectively. The 95％, 96％, 97％ confidence interval of the area under the ROC curve was 0. 991 ~ 1. 004. Conclusion Plasma BNP can be play an useful role in diagnosis of CP. But on the other hand, it can not be used in diagnosis of COPD.%目的:探讨慢性阻塞性肺病(COPD)、慢性阻塞性肺病伴肺源性心脏病(CP)患者血浆脑钠素(BNP)的变化及其临床诊断价值.方法:94例受试者分为COPD伴CP组31例,COPD组30例,正常对照组33例.定量检测各组血浆BNP水平,并绘制不同组受试者操作特征(ROC)曲线,观察ROC曲线下面积.结果:COPD伴CP组血浆BNP水平高于COPD组和正常对照组(均为P＜0.05),差异有统计学意义.COPD组和正常对照组血浆BNP水平差异不显著(P＞0.05).COPD伴CP患者ROC曲线分析,当BNP的截断值取61.5pg/ml时,敏感性和特异性分别为100%和97%,阳性预测值和阴性预测值分别为96%和97%,95%的可信区间为0.991～1.004.结论:血浆BNP对COPD患者诊断无意义,但对于COPD伴CP具有较高的诊断价值.