Discussion Of N-terminal Prohormone Brain Natriurctic Peptide In Patients With Chronic Pulmonary Heart Disease In Decompensated Period

Objective：To study the changes and clinical significance of N-terminal prohormonebrain natriurctic peptide in patients with chronic pulmonary heart disease indecompensated period. Method：The plasma level of NT-pro BNP was measured in69patients with chronicpulmonary heart disease in discompensation stage and52patients with chronicobstructive pulmonary disease(COPD) by using chemiluminescence in the day theyhospitalized. All of the patients hospitalized in respiratory department of the People’sHospital of Liaoning Province during January2012to January2013. Artery blood gasanalysis was done to record power of hydrogen (PH)、oxygen partial pressure (PO2)、partial pressure of carbon dioxide (PCO2)、total hemoglobin (ctHb) and cardiacultrasound examination was done to record diastolic diameter of right ventricular(RV)、width of right ventricular outflow tract (RVOT)、pulmonary artery pressure(PAP). Measuring the plasma level of NT-pro BNP again when all the patients were inremission after oxygen uptake, anti-infection, eliminating phlegm, preventing asthmaand nutritional supporting. The levels of NT-pro BNP in chronic pulmonary heartdisease group before and after treatment were compared and their correlations withother parameters were analyzed.Results：There was no statistical difference of age, gender, history of high bloodpressure, diabetes, smoking and drinking between the patients of the two groups.The level of NT-pro BNP in acute aggravating period [(6618±7775)pg/ml vs(734±1187)pg/ml]、PCO2[(62.3±19.4)mmHg vs (48.8±14.9)mmHg]、ctHb[(15.9±3.7)g/dl vs (13.1±1.5)g/dl]、RV[(26±9.56)mm vs (17±2.3)mm]、RVOT[(34±6.3)mm vs (26±2.9)mm]、PAP[(62±15.5)mmHg vs (26±2.1)mmHg]、NT-pro BNP in remission[(1516±1802)pg/ml vs (323±555)pg/ml] mm] in patients withchronic pulmonary heart disease were all higher significantly than those in the COPD group (all P<0.01). But PH[(7.34±0.089) vs (7.38±0.055)]、PO2[(59.5±19)mmHg vs(72.4±13.8)mmHg] in the chronic pulmonary heart disease group were lower than thatin the COPD group (all P＜0.01). The level of NT-pro BNP in acute aggravating periodwas higher than that in remittent stage within each group [(6618±7775)pg/ml vs(1516±1802)pg/ml、(734±1187)pg/ml vs (323±555)pg/ml](all P<0.01).The plasmatic level of NT-pro BNP was positively correlated with pulmonary arterypressure(r=0.449，P<0.05)、diastolic diameter of right ventricular (r=0.368,P<0.05)、width of right ventricular outflow tract (r=0.662， P＜0.05) and total hemoglobinconcentration(r=0.4，P＜0.05) in patients with chronic pulmonary heart disease indiscompensation stage. But relationship between NT-pro BNP and PO2was notsignificant. The plasmatic level of NT-pro BNP was positively correlated withpulmonary artery pressure (r=0.339，p＜0.05) in patients in COPD group, but was notproved a statistical significance with PO2(r=﹣0.179，p＞0.05)、ctHb(r=0.245，p＞0.05)、RV(r=0.252，p＞0.05)、RVOT(r=0.218，p＞0.05).Conclusion：The results suggest that NT-pro BNP is involved in the pathophysiologicprocess of chronic pulmonary heart disease. Estimating the level of NT-pro BNP couldbe helpful to judge the severity degree in chronic pulmonary heart disease.