摘要
目的:通过对C反应蛋白(CRP)、白介素(IL-6)、肿瘤坏死因子(TNF-α)及B型脑尿钠肽(BNP)的检测,观察炎症反应与慢性阻塞性肺疾病(COPD)并发肺动脉高压的关系。方法:收集首都医科大学附属北京安贞医院呼吸科及急诊重症监护病房,2011年9月至2012年7月收治的COPD患者80例,其中女性32例,男性48例;平均年龄(74±9)岁;平均FEV1%预计值为(59.4±29.4)%;根据彩色多普勒超声心动仪测定肺动脉收缩压;颗粒增强免疫透射比浊法(PETIA)测定血清CRP,酶联免疫吸附法(ELISA)测定血清IL-6及TNF-α,化学发光微粒子免疫检测法(CMIA)测定血浆BNP。结果:80例患者中COPD并发肺动脉高压组(A组)及COPD肺动脉压正常组(B组)各40例。A组CRP[中位数6.5(2.7～21.1)mg/L]、IL-6[中位数106.6(41.0-368.6)ng/L]、TNF-α[(19.4±10.2)ng/L]、BNP[中位数137.0(92.2～299.6)ng/L],均高于B组患者:CRP[中位数1.9(0.6～5.2)ng/L]、IL-6[中位数73.9(12.0～152.1)ng/L、TNF-α[(14.9±5.3)ng/L]、BNP[中位数45.1(20.4-98.5)ng/L]。各因子水平存在显著差异,且差异具有统计学意义(P<0.05)。Logistic回归分析提示CRP、BNP与COPD并发肺动脉高压相关。结论:COPD并发肺动脉高压患者CRP、IL-6、TNF-α及BNP较COPD肺动脉压正常患者高,提示炎症反应可能是COPD患者形成肺动脉高压的重要因素。
Objective：The purpose of the present study mainly aimed to investigate the degree of systemic inflammation reflected by circulatory levels of C reactive protein（CRP）,interleukin（IL）-6,tumor-necrosis factor（TNF）-α,and B-type brain natriuretic peptide（BNP）in COPD patients with and without pulmonary hypertension.Methods：A total of 80 COPD patients [32 females and 48 males;age,（74±9） years;mean FEV1%,（59.4%±29.4%） predicted] admitted to the department of respiratory medicine and the emergency intensive care unit of Beijing Anzhen Hospital were consecutively recruited from September of 2011 to July of 2012;pulmonary artery pressure（Ppa） levels were measured by echocardiography;serum CRP level was assessed by particle enhanced transmission immunoturbidimetry assay,serum IL-6、TNF-αwere measured by enzyme-linked immunosorbent assay,plasma BNP was measured by chemiluminescence microparticle immuno assay.Results：COPD with pulmonary hypertension group（A group） and COPD without pulmonary hypertension group（B group） were all have forty patients.In A group,CRP、IL-6、 TNF-αand BNP levels were significantly higher than in B group[median 6.5（2.7~21.1） vs.1.9（0.6~5.2）mg/L];[median 106.6（41.0-368.6） vs.73.9（12.0-152.1） ng/L];[mean（19.4±10.2） vs.（14.9±5.3）ng/L];[median 137.0（92.2-299.6） vs.45.1（20.4-98.5）ng/L].A significant linear relationship was observed between log-transformed CRP or log-transformed BNP level and systolic Ppa in whole group.In Logistic regression analysis,CRP and BNP were independent predictors of systolic Ppa.Conclusion： We conclude that increases in Ppa in patients with COPD are associated with higher levels of CRP、IL-6、TNF-α and BNP.It suggests that inflammation might be one of the key mechanisms involved in COPD with pulmonary hypertension patients.
出处
《心肺血管病杂志》
CAS
2013年第2期174-178,共5页
Journal of Cardiovascular and Pulmonary Diseases
关键词
肺疾病
慢性阻塞性
高血压
肺性
炎症
Pulmonary disease
Chronic obstructive
Hypertension
Pulmonary
Inflammation
