IL-6、NT-proBNP、CRP对COPD合并CPHD患者病情严重程度的预测价值  

Predictive value of IL-6,NT-proBNP,and CRP for the severity of COPD patients combined with CPHD

作　　者：许词 贾彦巍 Xu Ci;Jia Yanwei(Department of Blood Transfusion,Nanyang Central Hospital,Nanyang Henan 473000,China)

机构地区：[1]南阳市中心医院输血科,河南南阳473000

出　　处：《保健医学研究与实践》2022年第11期47-51,共5页Health Medicine Research and Practice

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20191450)。

摘　　要：目的探讨白细胞介素-6(IL-6)、N末端脑钠肽前体(NT-proBNP)、C反应蛋白(CRP)对慢性阻塞性肺疾病(COPD)合并慢性肺源性心脏病(CPHD)患者病情严重程度的预测价值,以期为临床治疗提供参考。方法选择2020年5月—2021年5月南阳市中心医院收治的158例COPD患者为研究对象,其中108例为COPD合并CPHD患者,其余50例为单纯性COPD患者。根据患者心脏衰竭程度将COPD合并CPHD组患者分成2个亚组:有呼吸衰竭及右心脏衰竭的患者归为肺心功能失代偿期组(A组,49例),未出现呼吸衰竭及右心脏衰竭的患者则归为肺心功能代偿期组(B组,59例)。本研究采用t检验、卡方检验、Spearman相关分析、受试者工作特征曲线(ROC)等统计学方法。结果COPD合并CPHD组患者IL-6、NT-proBNP、CRP水平高于COPD组,差异均具有统计学意义(P<0.05)。A组患者IL-6、NT-proBNP、CRP水平高于B组,差异均具有统计学意义(P<0.05)。IL-6、NT-proBNP、CRP水平与COPD合并CPHD患者病情严重程度呈正相关(P<0.05)。CRP检测对COPD合并CPHD严重程度的预测价值优于IL-6检测(P<0.05);NT-proBNP检测对COPD合并CPHD严重程度的预测价值优于CRP检测(P<0.05);IL-6、NT-proBNP、CRP联合检测(以任意一项指标为阳性即确诊)对COPD合并CPHD严重程度的预测价值优于各指标单项检测(P<0.05)。ROC结果显示:诊断COPD合并CPHD的各项指标中,IL-6截断值为17.755 pg/m L,CRP截断值为20.085 mg/L,NT-proBNP截断值为904.700 pg/m L。结论IL-6、NT-proBNP、CRP在COPD合并CPHD患者血清中呈高水平状态,IL-6、NT-proBNP、CRP与COPD合并CPHD患者病情严重程度相关,IL-6、NT-proBNP、CRP对COPD合并CPHD的诊断及病情评估有一定应用价值。Objective To investigate the predictive value of interleukin-6(IL-6),N-terminal pro-brain natriuretic peptide(NT-proBNP),and C-reactive protein(CRP)for the severity of chronic obstructive pulmonary disease(COPD)patients combined with chronic pulmonary heart disease(CPHD).Methods From May 2020 to May 2021,158 patients with COPD admitted to the Nanyang central hospital were enrolled in the study.Among them,108 patients had COPD combined with CPHD and the other 50 patients had COPD.According to the degree of heart failure,COPD patients combined with CPHD were allocated to two subgroups:patients with respiratory failure and right heart failure were classified as the pulmonary decompensation group(group A,n=49),and patients without respiratory failure and right heart failure were classified as the pulmonary compensation group(group B,n=59).The t-test,chi-square test,Spearman correlation analysis,and receiver operating characteristic curve(ROC)were adopted in this study.Results The levels of IL-6,NT-proBNP,and CRP in COPD patients combined with CPHD were significantly higher than those in COPD patients(P<0.05).IL-6,NT-proBNP,and CRP levels were significantly higher in group A patients than in group B(P<0.05).IL-6,NT-proBNP,and CRP levels were positively correlated with the severity of illness in COPD patients with CPHD(P<0.05).The predictive value of CRP detection for COPD with CPHD was significantly superior to IL-6 detection(P<0.05);the predictive value of NT-proBNP detection for COPD with CPHD was significantly superior to CRP detection(P<0.05);the predictive value of combined detection of IL-6,NT-proBNP,and CRP(confirmed by any index as positive)for COPD combined with CPHD was significantly superior to single detection of each index(P<0.05).ROC results showed that the IL-6 cutoff value was 17.755 pg/m L,the CRP cutoff value was 20.085 mg/L,and the NT-proBNP cutoff value was 904.700 pg/m L inthe diagnosis of COPD combined with CPHD.Conclusion IL-6,NT-proBNP,and CRP are present at high levels in the serum of COPD pat

关 键 词：慢性阻塞性肺疾病 慢性肺源性心脏病 预测价值 

分 类 号：R56[医药卫生—呼吸系统]