外周血Apelin、NO、NOS水平对慢阻肺急性加重期并发肺动脉高压的诊断价值  

Diagnostic values of Apelin,NO,and NOS levels in peripheral blood in patients with acute exacerbation of chronic obstructive pulmonary disease complicated with pulmonary hypertension

作　　者：鲍春 杨威 罗雯 BAO Chun;YANG Wei;LUO Wen(Department of Critical Care Medicine,The First Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150001,China;Department of Respiratory Medicine,The Third People′s Hospital of Shenzhen,Shenzhen,Guangdong 518000,China)

机构地区：[1]哈尔滨医科大学第一临床医学院重症医学科,黑龙江哈尔滨150001 [2]深圳市第三人民医院呼吸内科,广东深圳518000

出　　处：《临床肺科杂志》2023年第9期1352-1356,共5页Journal of Clinical Pulmonary Medicine

基　　金：黑龙江省卫生计生委科研课题(No.2018088)。

摘　　要：目的探讨外周血Apelin、一氧化氮(NO)、一氧化氮合酶(NOS)水平对慢阻肺急性加重期(AECOPD)并发肺动脉高压(PH)的诊断价值。方法选取2018年3月至2021年7月重症医学科收治的139例AECOPD患者设为AE组,同期选取门诊随诊的144例慢阻肺稳定期患者设为稳定期组,另选150例健康体检者设为对照组,检测外周血Apelin、NO、NOS水平。根据AE组超声心动图检测结果将其分为PH并发组和未并发组,分析AECOPD患者并发PH的影响因素,并评估血清指标对AECOPD患者并发PH的诊断价值。结果AE组和稳定期组外周血Apelin、NO、NOS水平均低于对照组(P<0.05),且AE组以上指标水平均更低(P<0.05);并发组外周血Apelin、NO、NOS水平均低于未并发组(P<0.05);吸烟史、氧分压降低、二氧化碳分压升高与第1s用力呼气容积占预计值百分比、第1s用力呼气容积/用力肺活量、外周血Apelin、NO、NOS水平降低均是AECOPD患者并发PH的危险因素(P<0.05);外周血Apelin、NO、NOS水平联合诊断AECOPD并发PH的灵敏度、曲线下面积均高于单独诊断(P均<0.05),其特异度与单独诊断无显著差异(P均>0.05)。结论AECOPD并发PH患者外周血Apelin、NO、NOS水平降低,与AECOPD患者并发PH有关,能帮助临床预测PH的发生。Objective To investigate the diagnostic values of peripheral blood Apelin,nitric oxide(NO),and nitric oxide synthase(NOS)in the evaluation of pulmonary hypertension(PH)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 139 patients with AECOPD admitted to the Department of Critical Care Medicine from March 2018 to July 2021 were selected as the AE group,and 144 patients with stable chronic obstructive pulmonary disease were selected as stable stage group at the same time,and 150 healthy persons were selected as control group.The levels of Apelin,NO,and NOS in the peripheral blood of the three groups were detected.In addition,According to the echocardiographic results of the AE group,the patients in the AE group were divided into PH concurrent group and nonconcurrent group according to the echocardiographic results.The influencing factors of PH in AECOPD patients were analyzed,and the diagnostic value of serum indicators in AECOPD patients complicated with PH was evaluated.Results The levels of Apelin,NO,and NOS in the peripheral blood of the AE group and stable group were lower than those of the control group(P<0.05),and the above indexes in the AE group were lower(P<0.05).The levels of Apelin,NO,and NOS in the peripheral blood of the complicated group were lower than those in the non-complicated group(P<0.05).Smoking history,a decrease of partial pressure of oxygen,an increase of partial pressure of carbon dioxide,and a decrease of forced expiratory volume in one second,forced expiratory volume 1/forced vital capacity,Apelin,NO,and NOS in peripheral blood were the risk factors of PH complicated by AECOPD(P<0.05).The sensitivity and area under the curve of combined diagnosis of peripheral blood Apelin,NO,and NOS levels in AECOPD complicated with PH were higher than those of single diagnosis(P<0.05),and there was no significant difference between their specificity and the diagnosis of the single index(P>0.05).Conclusion The levels of Apelin,NO,and NOS in the peripheral blo

关 键 词：APELIN 一氧化氮 一氧化氮合酶 肺动脉高压 慢性阻塞性肺疾病 

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