PCT BNP Hs-CRP及D-D联合检测在AECOPD伴PH中的价值  

The Value of Combined Detection of PCT,BNP,Hs-CRP,and D-D in Early Diagnosis and Prognosis of AECOPD Accompanied by PH

作　　者：李艳[1] 

机构地区：[1]成都市新都区人民医院呼吸内科,四川新都610500

出　　处：《贵州医科大学学报》2017年第9期1076-1080,共5页Journal of Guizhou Medical University

摘　　要：目的:探讨联合检测降钙素原(PCT)、脑尿钠肽(BNP)、超敏C-反应蛋白(hs-CRP)及D-二聚体(DD)在慢性阻塞性肺疾病急性加重(AECOPD)伴肺动脉高压(PH)早期识别、病情预后中的评估价值。方法:180例AECOPD患者,根据是否伴PH及AECOPD严重程度分为无PH组、轻度PH组、中度PH组、重度PH组及极重度PH组,比较入院时5组患者血清hs-CRP、D-D、NT-pro BNP及PCT水平,比较5组患者治疗后病情恢复至稳定期的比例;同时比较伴PH的AECOPD患者治疗后恢复至稳定期或死亡病例血清NT-pro BNP、Hs-CRP、PCT及D-D水平。结果:伴PH组患者入院时NT-pro BNP、Hs-CRP、PCT及D-D水平明显高于无PH组患者,随着PH严重程度的加重,患者的NT-pro BNP、Hs-CRP、PCT及D-D水平逐渐增高(P<0.05);无PH的AECOPD患者病情恢复至稳定期的比例明显高于伴PH组,轻度伴PH的AECOPD患者恢复至稳定期的比例明显高于重度和极重度伴PHAECOPD患者(P<0.05);经治疗后恢复至稳定期伴PH的AECOPD患者NT-pro BNP、Hs-CRP、PCT及D-D水平均明显低于治疗后无效死亡的伴PH患者(P<0.05)。结论:NT-pro BNP、Hs-CRP、PCT及D-D联合检测对早期诊断AECOPD伴PH并评估病情严重程度和预后有一定价值。Objective： To investigate the effect and value of combined detection of procalcitonin （PCT）, N-terminal pro-brain type natriuretic peptide （NT-proBNP）, high sensitivity C-reactive pro- tein （Hs-CRP） and D-dimer （D-D） in early diagnosis and prognosis of acute exacerbation of chronic obstructive pulmonary disease （AECOPD） accompanied by pulmonary hypertension （PH）. Methods： A retrospective analysis was conducted on the clinical data of 180 AECOPD patients. According to whether accompanied by PH or not and the severity of PH, the patients were divided into non-, mild-, moderate-, severe-, and extremely severe-PH groups. Serum levels of PCT, NT-proBNP, I-Is-CRP, and D-D of these patients on admission were detected. The ratio of recovery-stabe phase after treatment of the 5 groups were compared. As well, serum levels of PCT, NT-proBNP, Hs-CRP, and D-D of pa- tients with HP during recovery-stable phase were compared among groups and compared with those ca- ses of death. Results： Serum levels of PCT, NT-pruBNP, Hs-CRP, and D-D of AECOPD patients in PH groups were significantly higher than those of patients in group non-PH, and the levels increased a- long with the increase of PH severity （P 〈 0.05）. The ratio of recovery-stable phase in non-PH group was markedly higher than those in PH groups. The ratio of recovery-stable phase in group mild-PH was markedly higer than those in groups sever-PH and extremely severe-PH （P 〈 0.05 ）. Serum levels of PCT, NT-proBNP, Hs-CRP, and D-D of AECOPD patients in PH groups that recovered to stable phase were significantly lower than before treatment, and lower than those death cases. Conclusions： The joint detection of NT-proBNP, Hs-CRP, PCT, D-D is to some extent valuable in early diagnosis, and identification of AECOPD with PH, and in assessing the severity and prognosis of the disease.

关 键 词：慢性阻塞性肺疾病急性加重期 肺动脉高压 降钙素原 脑钠肽 C-反应蛋白 D-二聚体 

分 类 号：R563.3[医药卫生—呼吸系统]