C反应蛋白、脑利钠肽前体、D-二聚体在慢性阻塞性疾病伴肺动脉高压患者中的临床意义  

The clinical significance of c-reactive protein,NT-pro BNP and D-dimer in patients with chronic obstructive pulmonary disease complicated with pulmonary artery hypertension

作　　者：朱敏锋[1] 钱文霞[1] 陈丽秀[1] 高锋 Zhu Minfeng;QianWenxia;Chen Lixiu;Gao Feng(Department of Respiratory and Critical Care Medicine,The Affiliated Zhangjiagang Hospital of Soochow University,Zhangjiagang,Jiangsu,215600,China)

机构地区：[1]苏州大学附属张家港医院呼吸与危重症医学科,江苏张家港215600

出　　处：《当代医学》2020年第22期88-90,共3页Contemporary Medicine

摘　　要：目的探讨C反应蛋白(CRP)、脑利钠肽前体(NT-pro BNP)、D-二聚体(D-dimer)在慢性阻塞性疾病(COPD)伴有肺动脉高压(PH)患者中的临床意义。方法选取2018年7月至2019年7月本院收治的134例COPD患者,根据心超肺动脉压力分为COPD伴PH正常组、COPD伴轻度PH组、COPD伴中度PH组、COPD伴重度PH组,分别检测并比较上述4组患者入院时以及经治疗病情稳定后的血清CRP、NT-pro BNP、D-二聚体的水平差异,同时比较各组患者治疗前后CRP、NT-pro BNP、D-二聚体的变化。另外,以心超肺动脉压力情况为因变量,以治疗前的CRP、NT-proBNP和D-二聚体水平为自变量,进行多元Logistic回归分析。结果治疗前,随着肺动脉压力严重程度增加,CRP、NT-proBNP和D-二聚体水平均相应升高,4组间比较差异有统计学意义(P<0.05);治疗后,4组患者的血清CRP、NT-proBNP和D-二聚体水平均较治疗前有不同程度降低。治疗后,CRP:重度、中度、轻度组>正常组(P<0.05),轻度、中度和重度3组比较差异无统计学意义;NT-pro BNP:重度组>中度组>轻度组>正常组(P<0.05);D-二聚体:重度组>中度组>轻度组>正常组(P<0.05)。多元Logistic回归分析提示CRP、NT-pro BNP和D-二聚体均为肺动脉压力严重程度的危险因素。结论CRP、NT-proBNP、D-二聚体的水平在评估COPD伴肺动脉高压患者严重程度有一定价值,可作为COPD病情发展、治疗有效的参考指标。Objective To investigate the clinical significance of c-reactive protein(CRP),NT-pro BNP and D-dimer in patients with chronic obstructive pulmonary disease(COPD)complicated with pulmonary artery hypertension(PH).Methods 134 cases of COPD patients were selected from July 2018 to July 2019 in our hospital according to their the pulmonary artery pressure checking by echocardiographic were divided into COPD with normal pulmonaryartery pressure,COPD with mid pulmonary hypertension,COPD with moderate pulmonary hypertension,COPD with severe pulmonary hypertension.The different levels of the serum CRP,NT-pro BNP,D-dimer among the 4 groups on admission were detected and compared,and those were also comparedafter treatment when the condition is stable.Meanwhile,the changes of CRP,NT-pro BNP,D-dimer level in all patients of the 4 groupswereevaluated by serial determination of before and after the treatment.In addition,pulmonary artery pressure checking by echocardiographic was taken as the dependent variable,and CRP,NT-pro BNP and D-dimer levels before treatment were taken as independent variables for multivariate Logistic regression analysis.Results Before treatment,CRP,NT-pro BNP and D-dimer levels were increased with the increase of pulmonary artery pressure severity,which was statistically significant in the four groups(P<0.05).CRP,NT-pro BNP and D dimer levels in the 4 groups were all lower after treatment than before treatment.After treatment,CRP:severe,moderate and mild group>normal group(P<0.05),while there was no significant difference in mild,moderate and severe groups.NT-pro BNP:severe group>moderate group>mild group>normal group(P<0.05).D-dimer:severe group>moderate group>mild group>normal group(P<0.05).Multivariate Logistic regression analysis suggested that CRP,NT-pro BNP and D-dimer were risk factors for theseverity of pulmonary artery pressure.Conclusion CRP,NT-pro BNP and D-dimer levels are ofvalue in evaluating the severity of COPD patients with pulmonary hypertension,and can be used as a reference index f

关 键 词：C反应蛋白 脑利钠肽前体 D-二聚体 慢性阻塞性肺疾病 肺动脉高压 

分 类 号：R544.1[医药卫生—心血管疾病] R563.9[医药卫生—内科学]