25-(OH)D_3、NT-proBNP、PCT对老年慢性阻塞性肺疾病合并心力衰竭患者近期预后的影响  

Effects of 25-(OH)D_3, NT-proBNP and procalcitonin on short-term prognosis in elderly patients with chronic obstructive pulmonary disease complicated by heart failure

作　　者：杨红亮[1] 孟利敏[1] YANG Hong-liang;MENG Li-min(Department of Internal Medicine, Handan Area of General Hospital of Jizhong Energy Fengfeng Group, Hebei Province, Handan 056001, China)

机构地区：[1]河北省邯郸市冀中能源峰峰集团有限公司总医院邯郸院区内科,邯郸056001

出　　处：《中国循证心血管医学杂志》2017年第4期443-445,448,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨慢性阻塞性肺疾病合并心力衰竭患者血清25羟维生素D_3[25-(OH)D_3]、血清降钙素原(PCT)、N端脑钠肽前体(NT-proBNP)水平与心力衰竭严重程度及近期预后的关系。方法入选自2011年1月~2015年1月于河北省邯郸市冀中能源峰峰集团有限公司总医院邯郸院区内科就诊的80例老年慢性阻塞性肺疾病合并心力衰竭患者的资料进行回顾性分析,以死亡或随访6个月为终点事件,将病例组分为好转组和死亡组,同时选取同期于我院体检的80例老年健康体检者为对照组。测定血清25-(OH)D_3、NT-proBNP、PCT及高敏C反应蛋白(hs-CRP)水平,记录患者入院时心脏超声结果及随访6个月时间是否发生心血管事件(心力衰竭复发入院、心源性死亡或者恶性心律失常)。结果与对照组比较,病例组左心射血分数(LVEF)明显降低(P<0.05),而左心室舒张末期内径(LVEDD)及左心室收缩末期内径(LVESD)明显增高(P<0.05);血清25-(OH)D_3明显降低(P<0.05),NTproBNP、PCT及hs-CRP水平明显增高(P<0.05)。与好转组比较,死亡组LVEF明显降低(P<0.05),而LVEDD及LVESD明显增高(P<0.05)。血清25-(OH)D_3水平明显降低,而NT-proBNP、PCT及hsCRP水平明显高于好转组(P<0.05)。结论检测血清25-(OH)D_3、NT-proBNP、PCT水平对于评估慢性阻塞性肺疾病合并心力衰竭患者病情严重程度及预后具有重要的临床价值。Objective To investigate the relationship among the levels of serum25-hydroxyvitamin D3[25-(OH)D3],procalcitonin(PCT),N-terminal pro-brain natriuretic peptide(NT-proBNP),severity of heart failure and short-term prognosis in elderly patients with chronic obstructive pulmonary disease(COPD)complicated by heart failure.Methods The elderly patients with COPD complicated by heart failure(n=80)were chosen from the Department of Internal Medicine in Handan Area of General Hospital of Jizhong Energy Fengfeng Group from Jan.2011to Jan.2015,and their clinical data was retrospectively analyzed.The patients in case group were divided,taken death or6-month follow-up as endpoint events,into relief group and death group,and elderly healthy controls(n=80)were chosen into control group at the same time.The levels of25-(OH)D3,NT-proBNP,PCT and high sensitivity C-reactive protein(hs-CRP)were detected,and cardiac ultrasound results at hospitalization time and cardiovascular events(re-hospitalizing due to heart failure reoccurrence,cardiac death and malignant arrhythmia)during6-month follow-up period were recorded.Results Compared with control group,left ventricular ejectionfraction(LVEF)decreased significantly(P<0.05),and left ventricular end-diastolic inner diameter(LVEDd)and left ventricular end-systolic diameter(LVESd)increased significantly in case group(P<0.05).The level of serum25-(OH)D3decreased significantly(P<0.05),and levels of NT-proBNP,PCT and hs-CRP increased significantly(P<0.05)in case group.Compared with relief group,LVEF decreased significantly(P<0.05),and LVEDd and LVESd increased significantly(P<0.05)in death group.The level of serum25-(OH)D3decreased significantly,and levels of NT-proBNP,PCT and hs-CRP increased significantly(P<0.05)in death group.Conclusion The levels of25-(OH)D3,NT-proBNP and PCT have important clinical value in reviewing severity of heart failure and prognosis in elderly patients with COPD complicated by heart failure.

关 键 词：25羟维生素D3 降钙素原 N端脑钠肽前体 慢性阻塞性肺疾病 心力衰竭 

分 类 号：R563[医药卫生—呼吸系统]