血清GDF-15、BNP水平与慢性阻塞性肺疾病急性加重期患者肺动脉高压的相关性  

Correlation between serum GDF-15,BNP levels and pulmonary hypertension in patients with acute exacerbation stage of chronic obstructive pulmonary disease

作　　者：熊小平 张红丽[1] 席建宏[1] 拜合提尼沙·吐尔地[1] XIONG Xiaoping;ZHANG Hongli;XI Jianhong;Baihetinisa·Turdi(Department of Respiratory Intensive Care Unit,the First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830000,China)

机构地区：[1]新疆医科大学第一附属医院RICU,新疆乌鲁木齐830000

出　　处：《国际检验医学杂志》2021年第23期2890-2894,共5页International Journal of Laboratory Medicine

基　　金：新疆维吾尔自治区自然科学基金资助项目(2018D01C099)。

摘　　要：目的观察血清生长分化因子-15(GDF-15)、脑钠肽(BNP)在慢性阻塞性肺疾病急性加重期(AECOPD)患者中的表达水平,并分析二者与肺动脉高压(PH)的关系。方法选取2018年3月至2020年3月该院收治的93例AECOPD患者作为研究对象,入院时检测患者血清GDF-15、BNP水平,采集患者基线资料及实验室指标,根据患者是否发生PH分为PH组(34例)和无PH组(59例),重点比较PH与未发生PH患者入院时血清GDF-15、BNP水平,分析二者与AECOPD患者PH的关系。结果93例AECOPD患者经评估发现,有34例患者发生PH,发生率为36.56%;PH组患者血清C反应蛋白(CRP)、Toll样受体4(TLR4)、GDF-15、BNP水平均高于无PH组,差异均有统计学意义(P<0.05);经Logistic回归分析显示,CRP、TLR4、GDF-15、BNP过表达与AECOPD患者PH发生有关,可能是AECOPD患者PH发生的风险因子(OR>1,P<0.05);入院时血清GDF-15、BNP单独及联合检测预测AECOPD患者PH发生的受试者工作特征曲线下面积均>0.800,有一定预测价值;相关性检验发现,血清GDF-15、BNP水平之间呈正相关(r=0.152,P=0.040)。结论AECOPD患者入院时血清GDF-15、BNP水平异常表达与PH发生有一定联系,二者过表达可能是PH发生的风险因子,早期监测患者血清GDF-15、BNP水平,对预测AECOPD患者PH发生有一定价值。Objective To observe the expression levels of serum growth differentiation factor-15(GDF-15)and brain natriuretic peptide(BNP)in patients with acute exacerbation stage of chronic obstructive pulmonary disease(AECOPD),and analyze the relationship between the two and pulmonary hypertension(PH).Methods Selected 93 AECOPD patients admitted to this hospital from March 2018 to March 2020 as the research objects.Detected patients′serum GDF-15 and BNP levels at admission,collected patient baseline data and laboratory indicators,according to whether PH occured,patients were divided into PH group(34 cases)and non-PH group(59 cases),focused on comparing the serum GDF-15 and BNP levels of patients with PH and non-PH at admission,and analyzed the relationship between the two and the PH of AECOPD patients.Results After evaluation of 93 AECOPD patients,it was found that 34 patients had PH,with an incidence rate of 36.56%.The levels of serum C-reactive protein(CRP),Toll-like receptor 4(TLR4),GDF-15 and BNP in the PH group were higher than those in non-PH group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that the overexpression of CRP,TLR4,GDF-15,and BNP were related to the occurrence of PH in AECOPD patients,and might be a risk factor for the occurrence of PH in AECOPD patients(OR>1,P<0.05).The area under the receiver operating characteristic curve of serum GDF-15 and BNP alone and in combination at admission to predict PH in patients with AECOPD were>0.800,which had a certain predictive value.The correlation test found that there was a positive correlation between serum GDF-15 and BNP levels(r=0.152,P=0.040).Conclusion The abnormal expression of serum GDF-15 and BNP levels on admission of AECOPD patients is related to the occurrence of PH,and the overexpression of the two might be risk factors for the occurrence of PH.Early monitoring of serum GDF-15 and BNP levels in patients has certain value in predicting the occurrence of PH in patients with AECOPD.

关 键 词：慢性阻塞性肺疾病急性加重期 肺动脉高压 生长分化因子-15 脑钠肽 相关性 

分 类 号：R563[医药卫生—呼吸系统] R446.1[医药卫生—内科学]