肺心病肺动脉高压患者病情严重程度的影响因素分析  

Analysis of influencing factors on the severity of pulmonary heart disease and pulmonary arterial hypertension in patients

作　　者：李晓丽 朱丹 周素平 赵春丽 曾淑敏 LI Xiaoli;ZHU Dan;ZHOU Suping;ZHAO Chunli;ZENG Shumin(Cardiovascular Department,Hainan Chengmei Hospital,Haikou 570100,Hainan,China;Multidisciplinary Geriatric Diagnosis and Treatment Center,Hainan Chengmei Hospital,Haikou 570100,Hainan,China)

机构地区：[1]海南成美医院心血管内科,海南海口570100 [2]海南成美医院老年医学多学科诊疗中心,海南海口570100

出　　处：《中南医学科学杂志》2024年第5期786-789,共4页Medical Science Journal of Central South China

基　　金：海南省卫生健康委员会项目(22A2001016)。

摘　　要：目的 分析肺心病肺动脉高压患者病情严重程度的影响因素。方法 选择肺心病肺动脉高压患者219例,根据病情严重程度WHO心功能分级分为WHO-FCⅡ级组、Ⅲ级组、Ⅳ级组。比较各组血清B型脑钠肽(BNP)、高迁移率组蛋白B1(HMGB1)、白细胞介素-18(IL-18)水平、肺功能[用力肺活量(FVC)、第1秒用力呼气容积占预计值百分比(FEV_(1)%pred)、FEV_(1)/FVC]、心功能及血流动力学指标[肺毛细血管楔压(PCWP)、肺毛细血管阻力(PVR)、心排指数(CI)]。分析各指标的相关性以及肺心病肺动脉高压患者生存的影响因素。结果 随着患者心功能分级增加,血清BNP、HGMB1和IL-18水平增加,FEV_(1)%pred、FEV_(1)/FVC、PCWP、CI减少(P<0.05)。血清BNP、HGMB1、IL-18水平与FEV_(1)%pred、FEV_(1)/FVC、PCWP、CI均呈负相关(P<0.05)。BNP、HGMB1、IL-18是肺心病肺动脉高压患者病情严重程度和预后的影响因素(P<0.05)。结论 血清BNP、HGMB1和IL-18是肺心病肺动脉高压患者病情严重程度及预后的独立影响因素。Aim To analyze the influencing factors of the severity of pulmonary heart disease and pulmonary arterial hypertension in patients.Methods 219 patients with pulmonary heart disease and pulmonary arterial hypertension were selected and divided into WHO-FC grade Ⅱ,Ⅲ,and Ⅳ groups,respectively,according to the severity of their condition.The levels of serum B-type brain natriuretic peptide(BNP),high mobility histone B1(HMGB1),interleukin-18(IL-18),lung function [forced vital capacity(FVC),the forced expiratory volume in one second/predicted value ratio(FEV_1%pred),FEV_1/FVC],heart function and hemodynamic indicators [pulmonary capillary wedge pressure(PCWP),pulmonary vascular resistance(PVR),cardiac index(CI)] among different groups were compared.The correlation between various indicators and possible factors affecting the survival of patients with pulmonary heart disease and pulmonary arterial hypertension was analyzed.Results As the patient's cardiac function grading increases,the levels of serum BNP,HGMB1,and IL-18 increase,while FEV_1%pred,FEV_1/FVC,PCWP,and CI decrease(P<0.05).The levels of serum BNP,HGMB1,IL-18 were negatively correlated with FEV_1%pred,FEV_1/FVC,PCWP,and CI(P<0.05).BNP,HGMB1,and IL-18 were influencing factors on the severity and prognosis of pulmonary heart disease and pulmonary arterial hypertension patients(P<0.05).Conclusion Serum BNP,HGMB1,and IL-18 are independent influencing factors on the severity and prognosis of pulmonary heart disease and pulmonary arterial hypertension patients.

关 键 词：肺心病肺动脉高压 BNP HGMB1 IL-18 

分 类 号：R541.5[医药卫生—心血管疾病]