血清D-D、NT-proBNP及hs-CRP检测在老年慢性肺心病合并冠心病中的临床价值分析  

Clinical value of serum D-D,NT-pro BNP and hs-CRP in elderly patients with chronic pulmonary heart disease complicated with coronary heart disease

作　　者：王永[1] 范远威[1] 刘勇[1] 朱宝山[1] 

机构地区：[1]新沂市铁路医院呼吸科,江苏新沂221400

出　　处：《临床肺科杂志》2017年第11期2025-2027,2032,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨血清D-二聚体(D-D)、N-端脑利纳肽前体(NT-pro BNP)及超敏C反应蛋白(hsCRP)检测在老年慢性肺源性心脏病(CPHD)合并冠状动脉硬化性心脏病(CAHD)中的临床价值。方法 139例CPHD患者,按是否合并CAHD分为观察组(合并CAHD)和对照组(未合并CAHD)。两组患者分别在入院后24 h内及出院前抽取空腹肘静脉血行D-D、NT-pro BNP及hs-CRP等检查。结果 (1)两组患者NYHA心功能分级对比差异有统计学意义(P<0.01);(2)观察组治疗前血清D-D、NT-pro BNP及hs-CRP浓度均明显高于对照组(P<0.01);(3)观察组治疗后血清D-D、NT-pro BNP及hs-CRP浓度均明显下降,明显低于治疗前(P<0.01);(4)两组治疗后血清D-D、NT-pro BNP浓度对比差异均有统计学意义(P<0.01或P<0.05);(5)两组治疗后hs-CRP浓度对比差异无统计学意义(P>0.05)。结论血清NT-pro BNP、D-D及hs-CRP水平是CPHD合并CAHD患者疾病诊断、病情评估、治疗指导、疗效评价及评估预后的有效指标。Objective To investigate the clinical value of serum D-dimer （ D-D） , N-terminal pro-brain na-triuretic peptide （ NT-proBNP） and high sensitivity C-reactive protein （ hs-CRP） in the diagnosis of chronic pulmona-ry heart disease （ CPHD） complicated with coronary atherosclerotic heart disease （ CAHD） . Methods 139 patients with CPHD were divided into the observation group （ CAHD） and the control group （ not combined with CAHD） ac-cording to whether they were combined with CAHD. D-D, NT-proBNP and hs-CRP were examined in the two groups before and 24 h after admission respectively. Results ①There was significant difference in NYHA cardiac function classification between the two groups （P〈0. 01）. ② The serum levels of D-D, NT-proBNP and hs-CRP in the ob-servation group were significantly higher than those in the control group （P〈0. 01）. ③After treatment, serum D-D, NT-proBNP and hs-CRP concentrations decreased significantly in the observation group （ P〈0. 01 ） . ④ The differ-ences of serum D-D and NT-proBNP concentrations in the two groups after treatment were statistically significant （ P〈0. 01 or P〈0. 05 ） . ⑤ There was no significant difference in hs-CRP concentration after treatment between the two groups （P〉0. 05）. Conclusion The serum levels of NT-proBNP, D-D and hs-CRP are the effective indexes for the diagnosis, evaluation, treatment, evaluation and prognosis of CPHD patients complicated with CAHD.

关 键 词：D-二聚体 N-端脑利纳肽前体 超敏C反应蛋白 慢性肺源性心脏病 冠状动脉硬化性心脏病 

分 类 号：R541.4[医药卫生—心血管疾病] R541.5[医药卫生—内科学]