COPD患者血清胱抑素C、NT-proBNP、尿酸水平与病情严重程度及心脏受累的相关性分析  

The Correlations Between Levels of Serum Cystatin C,NT-proBNP and Uric Acid and Disease Severity and Cardiac Involvement in Patients with COPD

作　　者：邓正旭[1] 陈红[1] 文艳梅[1] 徐治波[1] DENG Zhengxu;CHEN Hong;WEN Yanmei;XU Zhibo(Second Department of Respiratory and Critical Care Medicine, Chengdu Second People’ s Hospital, Chengdu 610000, China)

机构地区：[1]成都市第二人民医院呼吸与危重症医学二科,四川成都610000

出　　处：《标记免疫分析与临床》2020年第3期471-475,496,共6页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)患者血清胱抑素C(CysC)、氨基末端脑钠肽前体(NT-proBNP)、尿酸(UA)、C反应蛋白(CRP)水平与病情严重程度及心脏受累的相关性。方法检测112例COPD患者的血清CysC、NT-proBNP、UA、CRP水平,治疗3个月后复查。测定并计算COPD患者的FEV1占预计值百分比(FEV1%预计值),分析CysC、NT-proBNP、UA、CRP与FEV1%预计值的相关性,用受试者工作曲线(ROC)分析CysC、NT-proBNP、UA、CRP对慢性肺源性心脏病(CCP)的诊断效能,计算曲线下面积(AUC)。结果COPD急性期患者血清CysC、NT-proBNP、UA、CRP水平高于COPD稳定期患者(P﹤0.05);Ⅳ级患者血清CysC水平高于Ⅰ、Ⅱ、Ⅲ级患者(P﹤0.05),血清NT-proBNP、UA水平比较,Ⅲ级﹥Ⅱ级﹥Ⅰ级(P﹤0.05),血清CRP比较,Ⅳ级﹥Ⅲ级﹥Ⅱ级﹥Ⅰ级(P﹤0.05);血清CysC、NT-proBNP、UA、CRP水平与FEV1%预计值呈显著负相关(P﹤0.05);合并CCP组患者血清CysC、NT-proBNP、UA、CRP水平高于无CCP组患者(P﹤0.05);血清CysC、NT-proBNP、UA、CRP诊断CCP的AUC值分别为0.602、0.932、0.770、0.682;COPD患者治疗3个月后血清CysC、NT-proBNP、UA、CRP水平均明显下降(P﹤0.05)。结论COPD患者血清CysC、NT-proBNP、UA、CRP水平与病情严重程度成显著正相关,对合并CCP也有较高的诊断价值,为COPD患者病情评估提供了重要的血清学依据。Objective To investigate the correlations between levels of serum cystatin C(CysC),N-terminal pro-brain natriuretic peptide(NT-proBNP),uric acid(UA)and C-reactive protein(CRP)and disease severity and cardiac involvement in patients with chronic obstructive pulmonary disease(COPD).Methods The levels of serum CysC,NT-proBNP,UA and CRP were measured among 112 COPD patients,and the re-examination was performed 3 months after the treatment.The percentage of FEV1 in the predicted value(FEV1%predicted value)was determined among COPD patients,and the correlations between CysC,NT-proBNP,UA and CRP and FEV1%predicted value were analyzed.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of CysC,NT-proBNP,UA and CRP on chronic cor pulmonale(CCP),and the area under the curve(AUC)was calculated.Results The serum levels of CysC,NT-proBNP,UA and CRP in patients with acute COPD were higher than those in patients with stable COPD(P<0.05).The serum CysC level in patients with grade IV was higher than that in patients with grades I,II or III(P<0.05).The comparison of serum NT-proBNP and UA showed a pattern as grade III>grade II>grade I(P<0.05),and comparison of serum CRP showed a pattern as grade IV>grade III>grade II>grade I(P<0.05).Serum levels of CysC,NT-proBNP,UA and CRP were significantly negatively correlated with FEV1%predicted value(P<0.05).The serum levels of CysC,NT-proBNP,UA and CRP in patients with CCP were higher than those in patients without CCP(P<0.05).The AUC values of serum CysC,NT-proBNP,UA and CRP in the diagnosis of CCP were 0.602,0.932,0.770 and 0.682,respectively.The levels of serum CysC,NT-proBNP,UA and CRP in patients with COPD were decreased significantly after 3 months of treatment(P<0.05).Conclusion The levels of serum CysC,NT-proBNP,UA and CRP in patients with COPD are significantly positively correlated with disease severity,and have a high diagnostic value on CCP,and they can provide an important serological basis for the assessment of COPD patients.

关 键 词：慢性阻塞性肺疾病 氨基末端脑钠肽前体 胱抑素C 尿酸 肺功能 慢性肺源性心脏病 

分 类 号：R563[医药卫生—呼吸系统]