目的探讨急诊COPD合并心衰患者检测NT-proBNP的临床意义。方法选取我院2010年3月~2012年10月收治的98例COPD患者作为研究对象,选取单纯COPD患者50例患者作为对照组,COPD合并心衰患者48例作为观察组,比较NT-proBNP水平组间差异及治疗前后差异。结果两组患者NT-proBNP及LVEF、LVFS水平比较均有显著差异（P＜0.01）,治疗后观察组NT-proBNP水平与对照组比较仍有显著差异（P＜0.01）,不同心功能分级患者NT-proBNP水平比较有显著差异（P＜0.01）。结论急诊可应用NTproBNP检测作为判断COPD是否合并心衰的可靠指标。

Objective To study the efficacy of adverse reaction of different dosages of mannitol in the treatment of elderly patients with acute large area cerebral infarction occurred.Methods Totally 114elderly patients with cerebral infarction diagnosed by craniocerebral CT or MRI were selected,and the infarction area was greater than 3cm2.They were randomly divided into low dose group and high dose group,and were given different dosages of mannitol,respectively.The clinical efficacy and safety in patients of the two groups were compared.Results The efficacy of low dose group and high dose group after treatment was 60.3%and 60.7%,respectively,there was no significant difference(P>0.05).The complications of the low dose group were fewer than the large dose group,both of them were compared,the difference was statistically significant(P<0.05).Conclusion Small dosages of mannitol in the treatment of acute large area cerebral infarction,can significantly reduce the electrolyte disorder and brain edema aggravated,it is worthy of clinical promotion.