Ghitelman Jaime, Krumerman Drew, Latif Farhana, Le Jemtel Thierry H
Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
Congest Heart Fail. 2004 Mar-Apr;10(2):106-8. doi: 10.1111/j.1527-5299.2004.03248.x.
A 52-year-old woman with chronic obstructive pulmonary disease (COPD) and chronic heart failure presented in respiratory distress. Physical examination could not differentiate COPD exacerbation from chronic heart failure decompensation. As her serum B-type natriuretic peptide level was 1030 pg/mL, she was initially treated for chronic heart failure decompensation. Serum B-type natriuretic peptide level fell to 308 pg/mL, but respiratory distress persisted. She was then treated with intravenous solumedrol for COPD exacerbation. Respiratory distress rapidly resolved. Serum B-type natriuretic peptide level is useful to detect heart failure in the presence of COPD but does not substitute for clinical judgment to initiate proper management.
一名患有慢性阻塞性肺疾病（COPD）和慢性心力衰竭的52岁女性出现呼吸窘迫。体格检查无法区分COPD急性加重和慢性心力衰竭失代偿。由于她的血清B型利钠肽水平为1030 pg/mL，最初她接受了慢性心力衰竭失代偿的治疗。血清B型利钠肽水平降至308 pg/mL，但呼吸窘迫仍持续存在。随后她接受了静脉注射甲泼尼龙治疗COPD急性加重。呼吸窘迫迅速缓解。血清B型利钠肽水平有助于在存在COPD的情况下检测心力衰竭，但不能替代临床判断来启动适当的治疗。
