NT-pro BNP、CRP和D-Dimer与慢性阻塞性肺疾病急性加重期合并肺动脉高压的相关性研究  

A Correlation Study of Serum NT-pro BNP,CRP and D-Dimer Levels in Patients of AECOPD Accompanied by Pulmonary Hypertension

作　　者：赵松林[1] 聂秀红[1] ZHAO Song-Lin;NIE Xiu-Hong(Xuanwu Hospital Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院,北京100053

出　　处：《标记免疫分析与临床》2019年第4期555-559,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨血清氨基末端脑钠肽前体(amino terminal pro-brain natriuretic peptide,NT-pro BNP)、C-反应蛋白(Creactive protein,CRP)、D-二聚体(D-Dimer)浓度是否与慢性阻塞性肺疾病急性加重期(acute exacerbation chronic obstructive pulmonary disease,AECOPD)合并肺动脉高压(pulmonary hypertension,PH)之间相关。方法选取首都医科大学宣武医院呼吸科2017年1月至2018年6月期间确诊的AECOPD患者,利用彩色多普勒超声心动图仪检测肺动脉收缩压并将患者分为肺动脉压正常组、肺动脉高压组,肺动脉高压组又分为轻度和中重度高压组,检测并比较不同组别之间NT-pro BNP、CRP和D-Dimer水平。结果共纳入113例AECOPD患者,包括53例肺动脉压正常者、36例轻度PH患者和24例中重度PH患者。肺动脉高压组各项指标[中位数(四分位间距)]分别为NT-pro BNP[633. 7 (492. 1～907. 3) pg/mL]、CRP[22.5 (12.9～34.1) mg/L]和D-Dimer[582.3 (472.9～794.4)μg/L],均显著高于肺动脉压正常组NT-pro BNP[307.4(221.7～442.6) pg/mL]、CRP[9.2 (6.5～15.7) mg/L]和D-Dimer[331.6 (247.1～465.4)μg/L]。此外,中重度PH组上述指标也均显著高于轻度PH组;logsitic回归分析提示NT-pro BNP、CRP以及D-Dimer浓度与AECOPD患者发生PH具有相关性,可作为PH的独立预测因子。结论 NT-pro BNP、CRP及D-Dimer等血清学指标与AECOPD患者发生PH及PH的严重程度具有相关性,可以作为其早期预警和评估严重程度的指标。Objective To investigate whether the serum levels of amino terminal pro-brain natriuretic peptide (NT-pro BNP),C-reactive protein (CRP) and D-Dimer are correlated with pulmonary hypertension (PH) found in patients of acute exacerbation chronic obstructive pulmonary disease (AECOPD).Methods Patients with AECOPD from the Department of Respiratory,Xuanwu Hospital,Capital Medical University from January,2017 to June,2018 were enrolled for the study.The systolic pulmonary artery pressure (SPAP) was measured by echocardiography and all patients were divided into the normal pressure group and pulmonary hypertension group (mild PH group,moderate-to-severe PH group) according to SPAP values.Serum levels of NT-pro BNP,CRP and D-Dimer were measured and compared among different groups.Results A total of 113 AECOPD patients were recruited,including 53 patients with normal pressure,36 with mild PH and 24 with moderate-to-severe PH.The serum levels [ M(P25 -P75)] of NT-pro BNP,CRP and D-Dimer in PH group were 633.7 (492.1-907.3) pg/mL,22.5 (12.9-34.1) mg/L and 582.3(472.9-794.4)μg/L,respectively,which were all significantly higher than those in the normal group:307.4(221.7-442.6) pg/mL,9.2(6.5-15.7)mg/L and 331.6(247.1-465.4)μg/L.In addition,these serum levels were also significantly higher in the moderate-to-severe PH group than in the mild PH group.Logistic regression analysis suggested NT-pro BNP,CRP and D-Dimer could be independent predictors of PH.Conclusion NT-pro BNP,CRP and D-Dimer are correlated with the occurrence and the severity of PH in AECOPD,and can be used as biomarkers for the early warning and severity estimation of PH.

关 键 词：氨基末端脑钠肽前体 C-反应蛋白 D-二聚体 慢性阻塞性肺疾病 肺动脉高压 

分 类 号：R563.9[医药卫生—呼吸系统] R544.1[医药卫生—内科学]