摘要
目的探讨研究N-端脑利钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)与凝血功能与动脉血气分析对慢性肺心病急性加重期患者的判断价值。方法选取在本院接诊治疗的300例慢性肺心病患者为研究对象,设为研究组,就诊时间均为2017年10月至2019年10月,选取同期在本院体检的60例健康人员对照组,根据诊断情况,研究组患者中112例慢性肺心病急性加重期患者为加重组,188例缓解期患者为缓解组,采用电化学发光仪测定NT-proBNP水平,采用血凝分析仪测定凝血酶时间(thrombin time,TT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、纤维蛋白原(fibrinogen,FIB)、D-二聚体(D-Dimer,D-D)、凝血酶原时间(prothrombin time,PT)水平,采用血气分析仪测定患者动脉血氧分压(arterial partial pressure of oxygen,PaO2)、动脉血二氧化碳分压(arterial partial pressure of carbon dioxide,PaCO2)和酸碱度(pondus hydrogenii,pH)。结果加重组患者NT-proBNP水平高于缓解组和对照组,缓解组高于对照组,差异有统计学意义(P<0.05),加重组pH、PaO2小于缓解组,加重组PaCO2大于缓解组,差异有统计学意义(P<0.05);对照组APTT低于加重组,缓解组和对照组PT、FIB、D-D均低于加重组,差异有统计学意义(P<0.05),缓解组D-D高于对照组,差异有统计学意义(P<0.05),3组之间TT两两比较,差异无统计学意义(P>0.05);加重组患者NT-proBNP、FIB、D-D水平与PaO2呈负相关,与PaCO2呈正相关(P<0.05);NT-proBNP曲线下面积为0.997,当截断值为335pg/mL时,诊断敏感性、特异性分别为100%、96%;FIB曲线下面积为0.955,当截断值为3.156g/L时,诊断敏感性、特异性分别为93%、83%;D-D曲线下面积为0.991,当截断值为0.729mg/L时,诊断敏感性、特异性分别为97%、94%(P<0.05)。结论NT-proBNP、FIB、D-D对慢性肺心病急性加重期患者疾病诊断具有一定的价值,且尤以NT-proBNP诊断价值最大。
Objective To explore the value of N-terminal pro-brain natriuretic peptide(NT-proBNP),coagulation function and arterial blood gas analysis in patients with acute exacerbation of chronic pulmonary heart disease.Methods Select 300 patients with chronic pulmonary heart disease treated in this hospital as the research object,and set it as the research group.The visit time is from October 2017 to October 2019.A control group of 60 healthy people who received physical examination in this hospital during the same period were selected.According to the diagnosis,112 patients in the acute exacerbation of chronic pulmonary heart disease in the study group were recombined,and 188 patients in remission were in the remission group.The level of NT-proBNP was measured by electrochemiluminescence instrument,and thrombin was measured by blood coagulation analyzer.Time(thrombin time,TT),activated partial thromboplastin time(APTT),fibrinogen(fibrinogen,FIB),D-dimer(D-Dimer,DD),prothrombin timeprothrombin time(PT)level,blood gas analyzer was used to measure the patient’s arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2)and pH(pondus hydrogenii,pH).Results The level of NT-proBNP in the recombined patients was higher than that of the remission group and the control group,and the remission group was higher than the control group(P<0.05).The pH and PaO2 of the recombination were lower than the remission group,and the recombination PaCO2 was greater than the remission group.(P<0.05);APTT of the control group is lower than that of the addition group,and the PT,FIB and DD of the remission group and the control group are lower than that of the addition group.The difference is statistically significant(P<0.05).There was no statistically significant difference in TT comparison between the three groups(P>0.05);the levels of NT-proBNP,FIB,DD and PaO2 were negatively correlated in patients with recombination,was positively correlated with PaCO2(P<0.05);the area under the NT-proBNP curve was 0.997,when
作者
赵智东
付会文
崔利锋
郭安
林怀印
孙涛
孙文豹
ZHAO Zhi-dong;FU Hui-wen;CUI Li-feng(Department of Respiratory and Gastroenterology,the Second People's Hospital of Hengshui,Hengshui 100191,China)
出处
《中国实验诊断学》
2020年第12期1934-1938,共5页
Chinese Journal of Laboratory Diagnosis
基金
河北衡水市科技计划项目(2017014040Z)。
关键词
凝血功能
慢性肺心病
动脉血气分析
N-端脑利钠肽前体
Coagulation function
Chronic pulmonary heart disease
Arterial blood gas analysis
N-terminal brain na-triuretic peptide precursor
