Objective: To investigate the changes of the levels of plasma brain natriuretic peptide (BNP) in patients with chronic obstructive pulmonary disease (COPD) and chronic cor pulmonale (CCP). Methods: Plasma BNP levels were detected in 30 patients with CCP at acute stage, compared with simple COPD group, and the rela tionship between it and PO2 , pulmonary artery pressure (PAP) was analyzed. Measurements were repeated in the same 30 patients with CCP at remission tage after therapy in hospital. Results: The levels of BNP at acute stage (262. 84 ± 47. 59)pg/ml and remission stage (128. 52 ±24. 82) pg/ml for CCP group were both higher than that in the simple COPD group (64.76 ± 12.03) pg/ml (P<0. 01). Plasma BNP levels were negatively correlated with PO2 (r=-0. 654, P<0. 01) at acute stage, but had no significant correlation at remission stage (P >0. 05). In the acute stage of CCP group, BNP levels in the plasma were positively correlated with the PAP(r=0. 763, P<0. 01). Con clusion: Hypoxia and pulmonary artery hypertension may result in elevation of plasma BNP in patients with COPD accompanied with CCP.BNP may involve in the pathophysiological process of CCP.%目的:探讨慢性阻塞性肺疾病(COPD)及慢性肺心病(CCP)患者血浆脑钠肽(BNP)的水平变化及临床意义.方法:将我科住院治疗的COPD患者60例分为单纯COPD组、CCP急性加重期及其缓解期组.CCP患者分别于急性加重期和缓解期测定血浆BNP水平,与单纯COPD组进行比较,并分析其与动脉血氧分压(PO2)、肺动脉收缩压(PAP)和收缩末期右室内径大小及右室/左室内径的相关性.结果:CCP急性加重期血浆BNP水平为262.84 ±47.59pg/ml,高于缓解期水平[128.52 ±24.82pg/ml,P<0.01],且两者均高于单纯COPD组[ 64.76±12.03pg/ml,P<0.01],急性加重期BNP水平与PO2呈负相关( r=-0.654,P<0.01),与PAP呈正相关(r=0.763,P<0.01),而缓解期BNP水平与PO2无显著相关性(P >0.05).结论:在COPD伴CCP患者中,血浆BNP水平上升,可能与缺氧、肺动脉高压(PAH)等因素相关.
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