降钙素原、D-二聚体、红细胞比容及血气分析在AECOPD合并肺动脉高压患者中的临床意义  

Clinical significance of PCT,D-dimer,HCT and arterial blood gas analysis in patients of acute exacerbation chronic obstructive pulmonary disease with pulmonary arterial hypertension

作　　者：盛艳玲[1] 李志娟[1] 杜新兴 王健兵[3] 袁雅冬[4] 张景[1] 

机构地区：[1]华北石油管理局总医院呼吸内科,任丘062552 [2]华北石油管理局总医院功能检查科,任丘062552 [3]华北石油管理局总医院心血管科,任丘062552 [4]河北医科大学第二医院呼吸科,石家庄050000

出　　处：《疑难病杂志》2015年第9期921-924,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的：探讨降钙素原（PCT）、D-二聚体（D-D）、红细胞比容（HCT）及血气分析在慢性阻塞性肺疾病急性加重期（AECOPD）合并肺动脉高压（PAH）患者中的意义。方法选取呼吸科住院治疗的AECOPD患者150例，根据心脏超声检测的肺动脉收缩压（PASP）值分为AECOPD合并PAH组（PAH组，PASP≥35 mmHg）76例和AECOPD无合并PAH组（无PAH组，PASP＜35 mmHg）74例。 PAH组依据PASP程度分为轻度亚组（PASP 35～50 mmHg）28例，中度亚组（PASP ＞50～70 mmHg）36例，重度亚组（PASP＞70 mmHg）12例；检测比较2组患者及各亚组间PCT、D-D、HCT及动脉血气分析，并将PASP与各项指标进行相关性分析。结果（1）PAH组患者PCT、D-D、HCT、PaCO2高于无PAH组患者，PaO2、SaO2低于无PAH组患者，差异有统计学意义（ t ＝－16．090、－19．968、45．643、16．403、9．624、9．709， P ＝0．000）。（2）重度亚组患者PCT、D-D 、HCT、PaCO2高于中度亚组，PaO2、SaO2低于中度亚组；中度亚组患者PCT、D-D、HCT、PaCO2高于轻度亚组，PaO2、SaO2低于轻度亚组，差异有统计学意义（ F ＝204．063、281．335、149．419、179．823、215．399、138．106， P ＝0．000）。（3） PCT、D-二聚体、HCT、PaCO2与PASP呈正相关（ r ＝0．982、0．983、0．979、0．987， P ＝0．000），PaO2、SaO2与PASP呈负相关（ r ＝－0．991、－0．966， P ＝0．000）。结论 PCT、D-D、HCT及动脉血气分析可以较好的反应AECOPD患者肺动脉高压程度，可以作为监测 AECOPD 合并PAH患者病情变化的指标。Objective To investigate the significance procalcitonin （ PCT ） , D-dimmer （ D-D ） , hematocrit value （HCT） and arterial blood gas analysis in patients of acute exacerbation chronic obstructive pulmonary disease （AECOPD） with pulmonary arterial hypertension（PAH）.Methods 76 hospitalized patients of AECOPD were enrolled as AECOPD combined PAH group（PASP≥35 mmHg）,and 74 hospitalized patients of AECOPD were enrolled as AECOPD without merge PAH group （ PASP﹤35 mmHg） according to their pulmonary artery systolic pressure （ PASP） checking by echocardiographic , AECOPD combined PAH group divided into three subgroups： 28 patients as mild pulmonary hypertension subgroup （ PASP 35 -50 mmHg） , 36 patients as moderate pulmonary hypertension subgroup （ PASP﹥50-70 mmHg） , 12 patients as severe pul-monary hypertension subgroup （ PASP﹥70 mmHg） , detected and compared the levels of PCT , D-D,HCT and arterial blood gas analysis of the two groups and the three subgroups;and analysis of the correlation between PASP and the various indica-tors.Results （1）ThePCT,D-D,HCT,PaCO2 of the AECOPD combined PAH group was obvious higher than those of AE-COPD without merge PAH group , the PaO2 ,SaO2 were obvious lower than those of AECOPD without merge PAH group （ t =-16.090,-19.968,45.643,6.403,9.624,9.709, P =0.000）.（2） The PCT,D-dimer,HCT,PaCO2 of severe PAH sub-group was obvious higher than of moderate PAH subgroup ,the PaO2 ,SaO2 was obvious lower than of moderate PAH subgroup;The PCT,D-dimer,HCT,PaCO2 of moderate PAH subgroup was obvious higher than of mild PAH subgroup ,the PaO2 ,SaO2 was＆amp;nbsp;obvious lower than of mild PAH subgroup （ F =204.063,281.335,149.419,179.823,215.399,138.106, P =0.000）.（3） PCT,D-dimer, HCT, PaCO2 have positive correlation with PASP （ r =0.982,0.983,0.979,0.987, P =0.000）;PaO2、SaO2 have negative correlation with PASP （ r =-0.991,-0.966, P =0.000）.Conclusion The PCT, D-dimer ,HCT and arteri-al blood gas analysis can better refl

关 键 词：降钙素原 D-二聚体 红细胞比容 血气分析 急性加重期 慢性阻塞性肺疾病 肺动脉高压 肺动脉收缩压 

分 类 号：R563.9[医药卫生—呼吸系统] R544.1[医药卫生—内科学]