| Objective: Chronic pulmonary heart disease(CHD)is a frequently occurring disease in the elderly.At present,the treatment of chronic pulmonary heart disease is mainly to maintain the treatment,improve the survival of patients.Therefore,the early diagnosis of patients is particularly important.In the diagnosis of chronic pulmonary heart disease,mainly rely on the patient's clinical manifestations,physical examination,ECG and other auxiliary examination,the lack of specific laboratory basis.There was a good correlation between plasma brain natriuretic peptide(B-type natriurefic peptide,BNP)and cardiac load.Plasma N-terminal brain natriuretic peptide(NT-pro BNP)is an N-terminal fragment that is not active after BNP hormone splitting.Compared with BNP,the half-life is longer and more stable,which reflects the activation of BNP pathway,plasma NT-pro BNP level Increased the degree of heart failure increased.Echocardiography is a noninvasive and reproducible method for the detection of cardiac and vascular function.In this study,the right ventricular systolic function index(TAPSE,Tei index)was used to evaluate the effects of pulmonary heart disease on right ventricular systolic function and pulmonary hypertension.And with the NT-pro BNP comparison of the above indicators have significance of evolution in the process of development and clinical guidance in pulmonary heart disease,provides a simple,noninvasive and reliable method for the diagnosis of pulmonary heart disease.Methods:In our hospital,the 176 cases of patients with chronic pulmonary heart disease were divided into two groups,includingdecompensated chronic pulmonary heart disease group(n=57)and chronic decompensated pulmonary heart disease group(n=119),and chronic decompensated pulmonary heart disease were divided into dyspnea group(n=42),right heart failure group(n=55)and heart failure group(n=22).At the same time,the normal control group(30 healthy people)were selected.The concentration of NT-Pro BNP in the serum of patients was measured by electrochemical luminescence method within 24 hours,and the systolic displacement of tricuspid annulus was detected by color Doppler ultrasonography,The right ventricular Tei index was observed.The pulmonary artery systolic pressure was calculated according to the simplified Bemoulli formula and the estimated right atrial pressure(RAP).Results:1 The concentration of NT-Pro BNP in patients with decompensated pulmonary heart disease was 301.34±43.22pg/ml The concentration of NT-Pro BNP was 734.12±52.32 pg/ml in patients with chronic pulmonary heart disease and dyspnea.The concentration of NT-Pro BNP in the right heart failure group was 2134.45 ± 521.42 pg/ml.The concentration of NT-Pro BNP in the whole heart failure group was 6345.56±3621.82pg/ml,and the concentration of NT-Pro BNP in normal subjects was 142.42±23.12pg/ml.(1)There were significant differences between the normal control group and the chronic cor pulmonale disease group(P<0.01).(2)There was significant difference between chronic cor pulmonale and decompensated stage of chronic cor pulmonale(P<0.01).(3)The difference of NT-pro BNP content between groups with chronic cor pulmonale was statistically significant(P<0.01)2 The systolic displacement of the tricuspid annulus was 22.72±2.01 mm in the control group,20.12±3.23 mm in the decompensated period,17.34±2.73 mm in the decompensated group and 12.14±2.47 mm in the right heart failure group,And 8.21±1.32 mm for the whole heart failure group.(1)There was significant difference between the compensatory period of chronic cor pulmonale and normal control group(P<0.01).(2)Comparing withthe compensatory period of chronic cor pulmonale,the difference was statistically significant(P<0.01).(3)There was also significant difference between chronic decompensated pulmonary heart disease group,dyspnea group,right heart failure group and heart failure(P<0.01)3 The right ventricular Tei index was 0.32±0.06 in the normal control group,0.49±0.12 in the decompensated pulmonary artery pressure group,0.64±0.11 in the chronic dyspnea group,0.72±0.15 in the right heart failure group,Group 0.91±0.13.(1)There were significant differences between the normal control group and th group e chronic cor pulmonale between the Tei values,the difference was statistically significant.(2)At the same time in the decompensated and decompensated chronic pulmonary heart disease between,Tei also have differences.(3)Tei values also differed significantly among the groups with decompensation of chronic lung disease(P<0.01).4 Pulmonary artery systolic pressure(PASP)was 23.56±3.10 mm Hg in the control group,32.45±5.25 mm Hg in the decompensated pulmonary arterial pressure group,36.45±4.02 mm Hg in the chronic decompensated group,44.12±3.45 mm Hg in the right heart failure group Heart failure group58.34±6.23 mm Hg.(1)There was significant difference between the normal group and the patients with chronic pulmonary heart disease(P<0.01),(2)At the same time,there was a significant difference(P<0.01)in pulmonary arterial pressure between decompensated and decompensated chronic pulmonary heart disease.(3)There was significant difference(P<0.01)between the two groups in the chronic decompensation period.There was significant correlation between N-terminal fragment of brain natriuretic peptide and right ventricular Tei index,pulmonary artery systolic pressure and systolic displacement of tricuspid annulus(P<0.01).The pearson coefficient of the N-terminal fragment of brain natriuretic peptide and right ventricular Tei index was 0.583,and the pearson coefficient of pulmonary artery systolic pressure was 0.675,and the pearson coefficient of tricuspid annulus was-0.609.The relationship between pulmonary artery pressure and tricuspid annulus systolic displacement and right ventricular Tei index pearsoncoefficient were-0.775 and 0.699,which were significantly correlated with the pulmonary artery pressure and right ventricular Tei index and tricuspid annulus systolic displacement correlation(P<0.01).Conclusion:1 The NT-Pro BNP concentration in the disease group was higher than that in the healthy group,and with the progress of the disease,the concentration increased,suggesting that NT-Pro BNP can effectively and effectively respond to the changes of chronic pulmonary heart disease;2 Three the systolic displacement,right ventricular Tei index and pulmonary artery pressure can be used as an effective index to measure the disease.Three the systolic displacement,right ventricular Tei index and pulmonary artery systolic pressure can effectively detect the changes of right ventricular function in patients with chronic pulmonary heart disease.3 There was a significant correlation between the concentration of NT-Pro BNP and the systolic displacement,right ventricular Tei index and systolic pressure of pulmonary artery in three cusps,which could be used as a standard for the diagnosis of chronic pulmonary heart disease. |
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