血清hs-CRP、BNP在慢性阻塞性肺疾病病情进展中的意义研究  

Significance of serum hs-CRP and BNP in the progression of chronic obstructive pulmonary disease

作　　者：张志 张奕然 杨中南 肖虹 张智亮 万冬宇[3] Zhang Zhi;Zhang Yiran;Yang Zhongnan;Xiao Hong;Zhang Zhiliang;Wan Dongyu(Cardio-Pulmonary Function Department,Zhengzhou Yihe Hospital,Zhengzhou 450000,China;Queen Mary College,Nanchang University,Nanchang 330031,China;Department of Cardiology,People’s Hospital of Zhengzhou,Zhengzhou 450000,China)

机构地区：[1]郑州颐和医院心肺功能科,450000 [2]南昌大学玛丽女王学院,330031 [3]郑州人民医院心内科,450000

出　　处：《国际医药卫生导报》2018年第23期3577-3581,共5页International Medicine and Health Guidance News

摘　　要：目的 探讨血清高敏C反应蛋白(hs-CRP)及B型脑钠尿肽(BNP)指标在慢性阻塞性肺疾病(COPD)进展至肺心病以及心力衰竭中的变化及意义。方法 收集2015年6月至2017年12月在本院呼吸科就诊的不同病情COPD患者,按照病情进展分为COPD组(102例)、肺心病组(76例)、心衰组(72例),收集健康体检者60例为健康对照组,并将心衰组按照心功能分为心衰Ⅰ级(16例)、心衰Ⅱ级(22例)、心衰Ⅲ级(20例)和心衰Ⅳ级组(14例)。检测并比较各组血清hs-CRP及BNP指标的差异,并在不同组间进行ROC曲线分析。结果 COPD组[hs-CRP:(16.2±6.6)mg/L,BNP:(182.6±68.4)ng/L]、肺心病组[hs-CRP:(27.7±4.6)mg/L,BNP:(242.0±105.8)ng/L]以及心衰组[hs-CRP:(58.8±35.6)mg/L,BNP:(297.5±235.6)ng/L]的血清hs-CRP和BNP含量均明显高于健康对照组[hs-CRP:(2.7±0.9)mg/L,BNP:(20.9±6.8)ng/L];且肺心病组明显高于COPD组(P<0.05),心衰组显著高于肺心病组和COPD组(P<0.05)。不同心功能等级的心衰患者的hs-CRP及BNP指标均存在统计学差异(P<0.05),心功能分级越高的患者血清hs-CRP及BNP含量越高。ROC结果表明hs-CRP在不同病例组间、不同心衰等级组间的分类性能较好,而BNP在不同病例组间分类较差,但在不同心衰组间分类性能较好。结论血清hs-CRP、BNP指标与COPD病情进展为肺心病、心衰以及心衰分级密切相关,指标越高表征病情越严重,在COPD病情诊断中具有一定意义。Objective To investigate the changes and significances of serum high sensitive C reactive protein(hs-CRP)and B type natriuretic peptide(BNP)in the process of chronic obstructive pulmonary disease(COPD)to pulmonary heart disease(PHD)and heart failure(HF).Methods 250 COPD patients with different condition in our hospital from June 2015 to December 2017 were collected and divided into COPD group(102 cases),PHD group(76 cases),and HF group(72 cases)according to the disease progression,60 health cases were collected as health control group(60 cases).Patients in heart failure group were classified into grade I group(n=16),grade II group(n=22),grade III group(n=20),and grade IV group(n=14)according to cardiac function.The serum hs-CRP and BNP were detected and compared among different groups,and ROC curve analysis was conducted among different groups.Results The contents of serum hs-CRP and BNP in COPD group[(16.2±6.6)mg/L,(182.6±68.4)ng/L],PHD group[(27.7±4.6)mg/L,(242.0±105.8)ng/L],and HF group[(58.8±35.6)mg/L,(297.5±235.6)ng/L]were significantly higher than those in health control group[(2.7±0.9)mg/L,(20.9±6.8)ng/L](P<0.05),and those in PHD group were significantly higher than those in COPD group(P<0.05),those in HF group were significantly higher than those in PHD group and COPD group(P<0.05).The levels of hs-CRP and BNP of patients with heart failure in different cardiac function classification were significantly different(P<0.05);the higher the cardiac function classification was,the higher the serum hs-CRP and BNP levels of patients were.The results of ROC showed that the classification performance of hs-CRP was better in different case groups and different heart failure grade groups,and the classification performance of BNP in different heart failure grade groups were better,but had poor classification performance in different case groups.Conclusion Serum hs-CRP and BNP index were closely related to COPD progression and heart failure classification.The higher the indexes were,the more serious the disease

关 键 词：高敏C反应蛋白 脑钠尿肽 慢性阻塞性肺疾病 肺心病 心力衰竭 

分 类 号：R563.9[医药卫生—呼吸系统]