血清CRP、RDW与NT-proBNP对不同严重程度慢性阻塞性肺疾病合并心力衰竭的预测价值  

Clinical Value of Serum CRP,RDW and NT-proBNP in Predicting Different Severity of Chronic Obstructive Pulmonary Disease Complicated with Heart Failure

作　　者：常凯悦 陈学前 CHANG Kaiyue;CHEN Xueqian(Department of Infectious Diseases,The First Affiliated Hospital of Xi'an Jiaotong University Yulin Hospital,Yulin Shaanxi 719000)

机构地区：[1]西安交通大学第一附属医院榆林医院感染性疾病科,陕西榆林719000 [2]安康市中医医院呼吸与危重症医学科,陕西安康725000

出　　处：《医学临床研究》2024年第1期39-42,46,共5页Journal of Clinical Research

摘　　要：【目的】探讨血清C反应蛋白(CRP)、红细胞分布宽度(RDW)与脑利钠肽前体(NT-proBNP)对不同严重程度慢性阻塞性肺疾病合并心力衰竭的预测价值。【方法】选取西安交通大学第一附属医院榆林医院感染性疾病科和安康市中医医院呼吸与危重症医学科2019年10月至2020年12月收治的90例慢性阻塞性肺疾病患者,按照检查结果和临床症状将患者分为单纯慢性阻塞性肺疾病组(单纯组,n=50)和慢性阻塞性肺疾病合并心力衰竭组(合并组,n=40),另选取同期健康体检志愿者50例作为对照组,比较三组血清CRP、RDW与NT-proBNP水平。将40例慢性阻塞性肺疾病合并心力衰竭组患者根据美国纽约心脏病学会(NYHA)分级分为Ⅱ级、Ⅲ级、Ⅳ级,比较不同分级患者血清CRP、RDW与NT-proBNP水平;比较不同严重程度患者CRP、RDW与NT-proBNP水平及近期疗效,采用受试者工作特征(ROC)曲线分析CRP、RDW与NT-proBNP联合对慢性阻塞性肺疾病患者合并心力衰竭的预测价值。【结果】单纯组、合并组血清CRP、RDW与NT-proBNP水平均高于对照组,合并组血清CRP、RDW与NT-proBNP水平高于单纯组(P<0.05);Ⅳ级、Ⅲ级慢性阻塞性肺疾病合并心力衰竭患者血清CRP、RDW与NT-proBNP水平高于Ⅱ级,Ⅳ级血清CRP、RDW与NT-proBNP水平高于Ⅲ级(P<0.05);慢性阻塞性肺疾病急性加重期患者血清CRP、RDW与NT-proBNP水平高于稳定期(P<0.05);稳定期患者临床疗效率高于急性加重期患者(P<0.05),血清CRP、RDW与NT-proBNP联合预测慢性阻塞性肺疾病患者合并心力衰竭的敏感度、特异度均高于单项检测。【结论】慢性阻塞性肺疾病合并心力衰竭患者血清CRP、RDW与NT-proBNP水平异常升高,其水平与疾病严重程度和预后密切相关,三者联合检测对于判断患者病情具有重要意义。【Objective】To investigate the clinical value of serum CRP(C-reactive protein),RDW(red blood cell distribution width)and NT-proBNP in predicting different severity of chronic obstructive pulmonary disease complicated with heart failure.【Methods】A total of 90 patients with chronic obstructive pulmonary disease(COPD)admitted to the Department of Infectious Diseases of The First Affiliated Hospital of Xi'an Jiaotong University Yulin Hospital,the Department of Respiratory and Critical Care Medicine of Ankang Hospital of Traditional Chinese Medicine from October 2019 to December 2020 were selected.According to the examination results and clinical manifestations,the patients were divided into the simple COPD group(50 cases)and the COPD combined with heart failure group(40 cases).Another 50 healthy volunteers who underwent physical examination during the same period were selected as the control group.The serum levels of CRP,RDW and NT-proBNP were compared among the three groups.Forty patients with COPD combined with heart failure group were further divided into gradeⅡ,ⅢandⅣaccording to cardiac function complianced with New York Heart Association classification(NYHA).Serum levels of CRP,RDW and NT-proBNP were compared among different grades.The relationship of short-term efficacy with levels of CRP,RDW and NT-proBNP in patients with different severity were analyzed.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of CRP,RDW and NT-proBNP alone and in combination in chronic obstructive pulmonary disease patients with heart failure.【Results】The levels of serum CRP,RDW and NT-proBNP in the simple COPD group and the COPD combined with heart failure group were higher than those in the control group.The levels of serum CRP,RDW and NT-proBNP in the COPD combined with heart failure group were higher than those in the simple COPD group(P<0.05).The levels of serum CRP,RDW and NT-proBNP in patients with gradeⅣandⅢCOPD combined with heart failure were higher than those in

关 键 词：肺疾病 慢性阻塞性/并发症 心力衰竭/并发症 C反应蛋白质/血液 红细胞指数/血液 利钠肽 脑/血液 

分 类 号：R563[医药卫生—呼吸系统]