慢性阻塞性肺疾病急性加重期并发肺动脉高压的危险因素  

Risk factors of pulmonary hypertension in acute exacerbation of chronic obstructive pulmonary disease

作　　者：徐明艳 韩校鹏 刘英丽 高帆[1] 刘剑波[1] XU Mingyan;HAN Xiaopeng;LIU Yingli;GAO Fan;LIU Jianbo(Department of Respiratory and Critical Care,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第二附属医院呼吸与危重症学科,郑州450000

出　　处：《实用医学杂志》2022年第19期2467-2471,共5页The Journal of Practical Medicine

基　　金：河南省医学科技攻关计划(联合共建)(编号:LH-GJ20190324)。

摘　　要：目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)并发肺动脉高压(PH)的危险因素,寻找潜在的预测指标。方法回顾性分析郑州大学第二附属医院2019年3月至2022年3月收治住院符合纳入标准的AECOPD患者120例,根据是否有PH将患者分为AECOPD组(n=59)和AECOPD并发PH组(n=61)。通过多因素logistic回归分析探究AECOPD并发PH的影响因素,采用受试者特征工作曲线(ROC曲线)分析各指标对AECOPD并发PH的诊断价值。结果AECOPD并发PH组的C反应蛋白与白蛋白比值(CAR)、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、白蛋白、淋巴细胞计数、中性粒细胞计数、凝血酶原时间、D-二聚体和N端脑钠肽前体(NT-proBNP)均高于AECOPD组(P<0.05);回归分析显示CAR、NT-proBNP和D-二聚体是AECOPD并发PH的独立危险因素(P<0.05);ROC曲线分析结果显示CAR、NT-proBNP和D-二聚体的AUC为0.854、0.885和0.729。结论CAR、NT-proBNP和D-二聚体较高的AECOPD患者并发PH的可能性越大。CAR和NT-proBNP对AECOPD并发PH诊断价值优于D-二聚体。Objective The of this study was to explore the risk factors of pulmonary hypertension(PH)in acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and to find potential predictors.Methods A retrospective analysis was made of 120 AECOPD patients who admitted to The Second Affiliated Hospital of Zhengzhou University from March 2019 to March 2022.According to the status of PH,patients were divided into AECOPD group(n=59)and AECOPD complicated with pH group(n=61).Multivariate logistic regression analysis was applied to explore the influencing factors of AECOPD complicated with PH.The receiver characteristic operating curve(ROC curve)was used to analyze the diagnostic value of each index for AECOPD complicated with PH.Results C-reactive protein to albumin ratio(CAR),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),C-reactive protein(CRP),interleukin-6(IL-6),albumin,lymphocyte count,neutrophil count,prothrombin time,D-dimer and N-terminal pro-brain natriuretic peptide(NT-proBNP)were higher than those in AECOPD group(P<0.05).Regression analysis showed that CAR,NT-proBNP and D-dimer were independent risk factors for AECOPD complicated with PH(P<0.05).The results of ROC curve analysis showed that the AUCs of CAR,NT-proBNP and D-dimer were 0.854,0.885 and 0.729.Conclusions AECOPD patients with higher CAR,NT-proBNP and D-dimer were more likely to develop PH.CAR and NT-proBNP are better than D-dimer in the diagnosis of AECOPD complicated with PH.

关 键 词：慢性阻塞性肺疾病 肺动脉高压 C反应蛋白与白蛋白比值 中性粒细胞与淋巴细胞比值 危险因素 

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