缺血修饰白蛋白和N末端B型脑钠肽前体对慢性阻塞性肺疾病合并肺源性心脏病患者的诊断及预后判断意义  

Significance of IMA and NT-proBNP levels in the diagnosis and prognosis of chronic obstructive pulmonary disease combined with pulmonary heart disease

作　　者：王丹萍[1] 曹奇峰[1] 瞿美君 肖兆群 王静[1] 狄松波 

机构地区：[1]台州市中西医结合医院呼吸内科,浙江台州317523

出　　处：《中国卫生检验杂志》2017年第8期1125-1127,共3页Chinese Journal of Health Laboratory Technology

基　　金：温岭市科学技术局科技项目(温财企[2014]25号-61)

摘　　要：目的分析缺血修饰白蛋白(IMA)和N末端B型脑钠肽前体(NT-proBNP)对慢性阻塞性肺疾病(COPD)合并肺源性心脏病患者的诊断及预后判断意义。方法收集COPD合并肺源性心脏病组121例,COPD稳定组92例。均在入院24 h内检测两组的白细胞(WBC)、血小板(PLT)、血红蛋白(Hb)、C-反应蛋白(CRP)、血肌酐(SCr)、血浆白蛋白(ALB)、IMA及NT-proBNP的浓度;再根据浓度中位值分为低浓度和高浓度,分析指标浓度与COPD合并肺源性心脏病患者死亡率的关系。结果 COPD合并肺源性心脏病组的PCT、IMA及NT-proBNP水平显著高于COPD稳定期组;ALB水平显著低于COPD稳定期组;低浓度的IMA及NT-proBNP患者病死率均分别显著低于高浓度患者的病死率;上述差异均有统计学意义(P<0.05)。结论 IMA和NT-proBNP浓度有助于COPD合并肺源性心脏病患者病情诊断及预后的判断。Objective To analyze the clinical significance of the levels of IMA and NT - proBNP in the diagnosis and prediction of prognosis for patients with chronic obstructive pulmonary disease （COPD） combined with pulmonary heart disease. Methods 121 cases were in chronic obstructive pulmonary diseases（COPD） combined with pulmonary heart disease group, and 92 cases were in stable COPD group. The concentrations of white blood cell（WBC） and platelet（PLT）, and the levels of hemoglobin（Hb）, C- reactive protein（CRP）, serum creatinine（SCr）, albumin（ALB）, proealcitonin（PCT）, ischemia modi- fied albumin（IMA） and N - terminal pro - B - type natriuretic peptide（ NT - proBNP） in all patients within 24 hours of admis- sion were detected. The difference of indexes mentioned above between two groups were compared, and then further divided into low -level and high - level. The relationship between levels of indexes and mortality was analyzed. Results The levels of PCT, IMA and NT - proBNP in COPD combined with pulmonary heart disease group were significantly higher that those of stable COPD group; the levels of ALB was significant lower that those of stable COPD group; the mortality rates of patients with low - level IMA or NT - proBNP were significantly higher than those of patients with high - levels, with all the differences above sta- tistically significant （P 〈 0.05）. Conclusion The levels of IMA and NT - proBNP were helpful to diagnose and estimate the prognosis for patients with COPD combined with pulmonary heart disease.

关 键 词：慢性阻塞性肺疾病合并肺源性心脏病 缺血修饰白蛋白 N末端B型脑钠肽前体 预后 

分 类 号：R541.5[医药卫生—心血管疾病]