cTnT、NT-proBNP、血尿酸水平与慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭预后的关系研究  

The relationship between the levels of cTnT,NT-proBNP,serum uric acid and the prognosis of chronic obstructive pulmonary disease with typeⅡrespiratory failure

作　　者：易福凌 李宁[1] 李永刚[1] 王禺[1] YI Fuling;LI Ning;LI Yonggang;WANG Yu(Department of Clinical Laboratory,Xi′an NO.1 Hospital,Xi′an,Shaanxi 710000,China)

机构地区：[1]陕西省西安市第一医院检验科,陕西西安710000

出　　处：《检验医学与临床》2020年第15期2146-2149,共4页Laboratory Medicine and Clinic

摘　　要：目的探究心肌肌钙蛋白(cTnT)、氨基末端B型利钠肽前体(NT-proBNP)、血尿酸水平与慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者预后的关系。方法选取2018年5月至2019年5月在该院住院治疗的82例慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者,根据1年后随访情况分为好转组(61例)和死亡组(21例),比较2组cTnT、NT-proBNP、血尿酸水平的差异,并分析上述指标与慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者预后的相关性。结果死亡组cTnT、NT-proBNP、血尿酸水平均显著高于好转组,差异有统计学意义(P<0.05)。相关性分析结果显示,cTnT、NT-proBNP、血尿酸水平、急性生理学与慢性健康状况Ⅱ评分与慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者死亡呈正相关(P<0.05)。受试者工作特征曲线分析结果显示,cTnT、NT-proBNP、血尿酸水平预测患者死亡的曲线下面积(AUC)分别为0.880、0.984、0.690,3项指标联合预测的AUC为0.985,cTnT、NT-proBNP、血尿酸水平单独及联合预测的灵敏度分别为95.2%、90.5%、47.6%、95.2%,特异度分别为67.2%、100.0%、88.5%、96.7%。结论cTnT、NT-proBNP、血尿酸水平与慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者的预后有关,检测以上指标能够判断患者的病情严重程度,及时进行有效的救治避免病情恶化,对改善疗效和预后有重要意义。Objective To explore the relationship between the level of cardiac troponin(cTnT),amino terminal B-type natriuretic peptide precursor(NT-proBNP),serum uric acid and the prognosis of patients with chronic obstructive pulmonary disease and typeⅡrespiratory failure.Methods From May 2018 to May 2019,82 patients with chronic obstructive pulmonary disease and typeⅡrespiratory failure were selected.According to the follow-up situation one year later,they were divided into the improvement group(61 cases)and the death group(21 cases).The differences of cTnT,NT-proBNP,serum uric acid levels between the two groups were compared,and the correlation between the above indicators and the prognosis of patients with chronic obstructive pulmonary disease and typeⅡrespiratory failure was analyzed.Results The levels of cTnT,NT-proBNP and serum uric acid in the death group were significantly higher than those in the improvement group(P<0.05).The results of correlation analysis showed that cTnT,NT-proBNP and serum uric acid and acute physiology and chronic healthⅡ(APACHEⅡ)score were positively correlated with chronic obstructive pulmonary disease with typeⅡrespiratory failure(P<0.05).The ROC curve analysis showed that the AUC of cTnT,NT-proBNP and serum uric acid were 0.880,0.984 and 0.690,respectively.The AUC of the three combined diagnosis was 0.985.The sensitivity of cTnT,NT-proBNP,serum uric acid alone and combination of the three indicators was 95.2%,90.5%,47.6%and 95.2%respectively,and the specificity was 67.2%,100.0%,88.5%and 96.7%respectively.Conclusion The levels of cTnT,NT-proBNP and serum uric acid are related to the prognosis of patients with chronic obstructive pulmonary disease and typeⅡrespiratory failure.The detection of the above indicators can judge the degree of the patients′condition,timely and effective treatment can avoid the deterioration of the condition,which is of great significance to improve the curative effect and prognosis.

关 键 词：心肌肌钙蛋白 氨基末端B型利钠肽前体 血尿酸 慢性阻塞性肺疾病 Ⅱ型呼吸衰竭 

分 类 号：R446.1[医药卫生—诊断学] R563.8[医药卫生—临床医学]