| Brain natriuretic peptide(BNP), also known as b-type natriuretic peptide, is named from the pig brain purified process by a Japanese researcher, which is an important family member of natriuretic peptide(heart hormone). Serum BNP level is an important biochemical marker of heart disease, more than that, some recent studies have pointed that the BNP are showing various levels in pulmonary embolism, pneumonia, COPD patients and other respiratory system diseases. Chronic obstructive pulmonary disease(COPD) is a kind of limited airflow chronic lung disease with clinical progressive development which leads to fully irreversible airflow limitation. The main outside pathogenic factors includes inhaling harmful particles, gases(such as smoke, cigarette) and other materials which lead to the abnormal airway inflammation. Chronic pulmonary heart diseases, the so called cor pulmonale, result from chronic diseases such as pulmonary vascular lesions, thoracic and lung diseases. Even more, the Chronic bronchial caused abnormal structure and function of lung tissue then increasing pulmonary resistance and rising pulmonary artery pressure. With the persistent artery pressure it is easy leading to the right heart hypertrophy, expansion, function and structure changing even right heart failure. Most of the corpulmonale were evolved from the repeating aggravation of COPD. The clinical recurrent and progressive aggravation of corpulmonale brings terrible damages to vital organs even the whole body. Most of the long-term prognosis is far too optimistic, clinical mortality rate is reaching to 50%. In consequence, an early prevention or intervention should be taken in diagnosis chronic pulmonary heart disease. In this study, BNP expression in different stages of COPD and Chronic pulmonary heart disease were observed, and their relevance was summarized to determine the diagnostic value of BNP in COPD and Chronic pulmonary heart disease..Objective: To research the diagnostic value of the sodium recombinant human brain peptide in different conditions of COPD.Methods: 36 patients with AECOPD;32 patients with COPD and pulmonary hypertension; 68 patients with acute episode of chronic corpulmonale were treated by our department from October 2012 to October 2014. 38 patients with COPD stable period in outpatient service,and 80 health persons as the control group. All objects involved in the researching were inspected on an empty stomach, 2 ml venous blood was taken, and put into the EDTA anticoagulant tube, plasma centrifugalizing, then stored in refrigerator. Triage BNP detector(Boisite Company, USA) was applied to test BNP samples. The testing methods in controlling quality parameters and the various quality indexes are all in the controllable range. The patients in the period of acute aggravating were hospitalized and treated with anti-infection, spasmolysis and asthma, which could relieve cough, reduce sputum and low flow oxygen therapy.Results: There were differences in statistically significant(P<0.05) of pulmonary artery pressure between the two COPD groups. There was differences in statistically significant(P<0.05) of BNP numerical between the normal pulmonary artery pressure group and pulmonary hypertension group; The BNP level of acute aggravating group was significantly higher(P<0.05) than stable phase group. Blood oxygen partial pressure of acute aggravating patients were lower(P<0.05) compared with the stable group; The BNP of COPD patients is significantly higher(P<0.05) than physical examination group. The average 51.32 mm Hg of oxygen partial pressure is significantly lower(P<0.05) than 88.89 mm Hg of the normal group. The right ventricular size, right ventricular/left ventricular and ejection fraction(EF) value of two groups were at comparable scales. Chronic pulmonary heart disease patients’ plasma BNP value is reaching 258.21 pg/ml, and the healthy controls only got 4.31 pg/ml; In this research, there are 38 cases of patients with pneumocardial compensation, and 30 cases with pneumocardial decompensation. The plasma BNP and arterial blood oxygen partial pressure(Pa O2) in different patients of cardiac function are statistically difference(P<0.05); After fully treatment, the blood oxygen partial pressure of patients improved significantly, compared with the situation before, we can see the differences are statistically significant(P<0.05); After being treatment the plasma BNP values significantly lower than before(P<0.05); Stroke volume(SV) per minute increased from 47.37 ml before to 60.16 ml, cardiac output(CO) raised from 2.91 L to 4.03 L, ejection fraction goes from 38.91% to 46.12%, all the above subjects have differences in statistically significant(P<0.05); In this research, the prognosis of 48 patients with chronic pulmonary heart disease are recovered in good condition, 20 of them are not. The plasma BNP of the 48 have an average 157.33 pg/ml which was lower than the 20 patients’ average 341.89 pg/ml. The blood oxygen partial pressure in the 48 patients with good prognosis was obviously higher than that of 20 patients group(P<0.05).Conclusion: BNP is taken part in the pathological process of COPD and chronic pulmonary heart disease. The plasma brain natriuretic peptide level can be considered as a helpful index to estimate the states of illness, following-up the treatment efficacy and evaluate the prognosis. |
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