心血管参数和IL-38在慢性阻塞性肺疾病急性加重并发肺栓塞中的研究分析  

Analysis of cardiovascular parameters and IL-38 in acute exacerbation of chronic obstructive pulmonary disease complicated with pulmonary embolism

作　　者：杜娟 DU Juan(Medical and Technical Ultrasound Department,Huaxian People‘s Hospital,Anyang Henan 456400,China)

机构地区：[1]滑县人民医院医技彩超室,河南安阳456400

出　　处：《临床研究》2023年第5期136-139,共4页Clinical Research

摘　　要：目的探究心血管参数和白细胞介素-38(IL-38)在慢性阻塞性肺疾病急性加重(AECOPD)并发肺栓塞中的变化情况。方法选取滑县人民医院2018年1月至2019年10月收治的AECOPD合并肺栓塞32例患者(研究组)。另选取同期本院收治的未合并出现肺栓塞的AECOPD患者60例(对照组)。进行前瞻性实验研究。所有患者均进行D-二聚体、C-反应蛋白(CRP)、IL-38等生化指标检测,并监测二氧化碳分压、肺动脉收缩压及氧合指数(PaO 2/FiO 2),同时进行肺血管CT成像及心脏彩超检测,计算栓塞指数,比较两组患者心脏彩超检测中的各项心血管参数差异,分析栓塞指数、IL-38与心血管参数的相关性。结果研究组患者D-二聚体、二氧化碳分压、肺动脉收缩压、C-反应蛋白(CRP)、纤维蛋白原(FIB)、氨基N末端B型利钠肽前体(NT-proBNP)水平高于对照组,IL-38、PaO 2/FiO 2水平低于对照组,差异有统计学意义(P<0.05)。研究组白细胞计数(WBC)水平高于对照组,差异无统计学意义(P>0.05)。研究组患者右心室舒张末期容积(RVEDV)、右室收缩末期容积(RVESV)、右室流出道(ROVT)、舒张晚期峰值速度(Am)、肺动脉压力(PAP)、肺动脉内径(PA)、右室内径(RV)大于/高于对照组,右室射血分数(RVEF)、舒张早期峰值速度(Em)小于对照组,差异有统计学意义(P<0.05);两组患者左心射血分数(LVEF)、二尖瓣口血流速度(MV)、三尖瓣口血流速度(Tv)、左室内径(LV)差异无统计学意义(P>0.05)。研究组和对照组的栓塞指数分别为0.52±0.03、0.32±0.06,经过相关性分析结果可见,栓塞指数与RVEDV、RVESV、ROVT、Am、PAP、PA、RV呈现正相关关系(r=0.367,0.185,0.425,0.362,0.215,0.126,0.205,P<0.05),与RVEF、Em、IL-38呈现负相关关系(r=-0.267,-0.362,-0.285,P<0.05)。结论心脏彩超有助于对AECOPD肺栓塞患者进行确诊分析,AECOPD患者IL-38水平降低,各项心血管参数异常,提示患者存在肺栓塞风险,监测IL-38水平对�Objective To investigate the changes in cardiovascular parameters and interleukin-38(IL-38)in acute exacerbations of chronic obstructive pulmonary disease(AECOPD)complicated by pulmonary embolism.Methods Thirtytwo patients with AECOPD combined with pulmonary embolism admitted to the Huaxian People‘s Hospital from January 2018 to October 2019 were selected(study group).Another 60 patients with AECOPD who did not have pulmonary embolism in combination admitted to our hospital during the same period were selected(control group).A prospective study was conducted.All patients were tested for D-dimer,C-reactive protein(CRP),IL-38 and other biochemical parameters,and carbon dioxide partial pressure,pulmonary artery systolic pressure and PaO2/FiO2 were monitored.The correlation between embolic index,IL-38 and cardiovascular parameters was analyzed.Results Compared with the control group,patients in the study group had increased D-dimer,CRP,FIB,NT-proBNP,and increased partial pressure of carbon dioxide and pulmonary artery systolic pressure,and decreased IL-38 and PaO2/FiO2,with significant differences(P<0.05)Patients in the study group had increased right ventricular end-diastolic volume(RVEDV),right ventricular end-systolic volume(RVESV),right ventricular outflow tract(ROVT),peak late diastolic velocity(Am),pulmonary artery pressure(PAP),pulmonary artery internal diameter(PA),and right ventricular internal diameter(RV)were greater/greater than those in the control group,and right ventricular ejection fraction(RVEF)and peak early diastolic velocity(Em)were less than those in the control group(P<0.05);ventricular and mitral orifice flow velocity(MV),and There was no significant difference in ventricular and mitral orifice velocity(MV),tricuspid orifice velocity(Tv),and left ventricular diameter(LV)between the two groups(P>0.05);the embolic index was 0.52±0.03 and 0.32±0.06 in the study group and the control group,respectively,and after correlation analysis,it was seen that the embolic index showed a positive correlati

关 键 词：慢性阻塞性肺疾病 肺栓塞 心脏彩超 心血管参数 白细胞介素-38 D-二聚体 C-反应蛋白 诊断 

分 类 号：R563.5[医药卫生—呼吸系统]