摘要
目的研究慢性肺心病急性加重期(acute exacerbation of chronic cor pulmonale,AECCP)患者血清脑钠肽(BNP)水平与凝血功能变化的相关性,并探讨其可能机制和临床意义。方法调查我院2011年1月至2014年6月140例AECCP住院患者血清BNP和血浆凝血酶原时间(PT),活化部分凝血活酶时间(aPTT),纤维蛋白原(Fbg),凝血酶时间(TT)的水平,与30例正常人比较,分析AECCP患者BNP水平与凝血功能的量变关系。结果 AECCP患者BNP,PT,Fbg,TT水平明显高于正常人(均P<0.01);死亡组患者BNP水平明显高于生存组(P<0.01);BNP对死亡风险预计的ROC曲线下面积(AUC)为0.678(95%可信区间为0.567-0.789;P<0.01),以BNP=500 ng/L为死亡预计界点,敏感度为58%,特异性为67%;BNP与PT,aPTT水平呈正相关(分别为r=0.0.229,P<0.01和r=0.193,P<0.05),与Fbg水平呈负相关(r=-0.282,P<0.01)。结论易栓和出血倾向状态通常同时存在于AECCP患者当中,凝血功能紊乱与心衰程度密切相关,血清BNP水平可作为判断AECCP患者预后的指标。
Objective To research the relationship between levels of brain natriuretic peptide and blood coagulation function in the patients with acute exacerbation of chronic cor pulmonale（AECCP） and dis- cuss the possible mechanism and clinical significance. Methods A retrospective analysis was made based on 30 healthy individuals and 140 cases in our hospital with AECCP from January 2011 to June 2014. Levels of brain natriuretic peptide （ BNP）, prothrombin time （ PT）, activated partial thromboplastin time （ aPTY）, fibrino- geM（Fbg） and thrombin time （TT） in the patients were assessed. Results The patients had higher levels of BNP,PT,Fbg,TT（ allP 〈 0. 01 ）as compared with the healthy ones. Compared with the survival patients, the death had higher level of BNP（P 〈 0. 01 ）. Significantly positive correlations were found between the levels of BNP,PT and aPTT（r =0. 229 ,P 〈0.01 and r =0. 193 ,P 〈0.05 respectively） ,and a negative correlation ex- isted between the levels of BNP and Fbg（ r = -0. 282 ,P 〈 0.01 ）. The area under receiver operating character- istic curve of BNP predicting the prognosis was 0. 678, （95% confidence interval：0. 567 to 0. 789 ;P 〈 0. 01 ） . When BNP was 500 ng/L as a cut-off value, the sensitivity was 58% and specificity 67%. Conclusion Thrombophilia and bleeding tendency usually coexist in the patients with AECCP, and coagulation disorders may associate with the severity of heart failure. Level of BNP may be a predictor of prognosis for the patients.
出处
《血栓与止血学》
2015年第3期144-146,共3页
Chinese Journal of Thrombosis and Hemostasis
基金
广东省医学科学技术研究基金项目(A2013265)
关键词
慢性肺心病
凝血机制
脑钠肽
Chronic cor pulmonale
Coagulation mechanism
Brain natriuretic peptide
