摘要
目的检测慢性阻塞性肺疾病(COPD)病人外周血中内皮素-1(ET-1)、C反应蛋白(CRP)和N-末端脑钠肽前体(NTproBNP)水平,分析预测COPD合并肺动脉高压(PAH)的临床价值。方法纳入2018年10月至2021年10月在平煤神马医疗集团总医院接受治疗的稳定期COPD病人114例,根据病人是否合PAH将病人分为COPD组(n=72)和COPD合并肺动脉高压组(n=42)。全自动生化分析仪检测白细胞(WBC)、红细胞(RBC)、血红蛋白(Hb)、中性粒细胞、淋巴细胞、血小板、单核细胞、白蛋白、总胆红素和血肌酐水平,并计算中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)。血气分析仪测定血乳酸水平,电化学发光免疫法检测NT-proBNP水平和酶联免疫吸附试验检测CRP和ET-1的水平。分析影响COPD合并肺动脉高压的危险因素,采用受试者操作特征(ROC)曲线评估CRP、ET-1和NT-proBNP预测COPD合并PAH的临床价值。结果COPD合并PAH组与COPD组相比,淋巴细胞和白蛋白水平降低,NLR、PLR、D-二聚体、血肌酐、乳酸水平增加,COPD合并PAH组NT-proBNP[523.25(184.20,1460.36)ng/L]、CRP[(45.47(30.47,78.21)mg/L]和ET-1[1425.25(726.41,1820.14)μg/L],高于COPD组[523.25(184.20,1460.36)ng/L、14.21(5.32,25.81)mg/L、752.58(501.32,814.72)μg/L],组间比较差异有统计学意义(P<0.05)。多因素logistic回归分析显示NT-proBNP、CRP和ET-1水平增加为影响COPD合并PAH的危险因素(P<0.05)。NT-proBNP、CRP和ET-1联合检测预测COPD合并PAH的曲线下面积为0.92,大于NT-proBNP、CRP和ET-1的单独检测0.77、0.78和0.86(Z=6.25、5.96、3.96,均P<0.05)。结论NT-proBNP、CRP和ET-1水平增加是COPD合并PAH的独立危险因素,联合预测COPD合并肺动脉高压的临床价值高于单独检测。
Objective To detect the levels of endothelin-1(ET-1),C-reactive protein(CRP)and N-terminal precursor brain natriuretic peptide(NT-proBNP)in peripheral blood of patients with chronic obstructive pulmonary disease(COPD),and analyze the clinical value of predicting COPD complicated with pulmonary hypertension(PAH).Methods A total of 114 stable COPD patients who were treated in Pingmei Shenma Group General Hospital from October 2018 to October 2021 were enrolled.The patients were assigned into COPD group(n=72)and COPD complicated with PAH group(n=42),according to whether they were complicated with PAH.The automatic biochemical analyzer detected the levels of white blood cells(WBC),red blood cells(RBC),hemoglobin(Hb),neutrophils,lymphocytes,platelets,monocytes,albumin,total bilirubin and serum creatinine,and calculated the neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR).The blood lactate level was measured by blood gas analyzer,the level of NT-proBNP was detected by electrochemiluminescence immunoassay,and the levels of CRP and ET-1 were detected by enzyme-linked immunosorbent assay.The risk factors affecting COPD complicated with pulmonary hypertension were analyzed,and the receiver operating curve was used to evaluate the clinical value of CRP and ET-1 in predicting COPD complicated with PAH.Results Compared with the COPD group,the levels of lymphocyte and albumin were decreased,and the levels of NLR,PLR,D-dimer,serum creatinine and lactic acid were increased in COPD group combined with PAH.NT-proBNP[523.25(184.20,1460.36)n g/L],CRP[45.47(30.47,78.21)mg/L]and ET-1[1425.25(726.41,1820.14)μg/L]in COPD combined with PAH group were higher than NT-proBNP[523.25(184.20,1460.36)ng/L,14.21(5.32,25.81)mg/L,752.58(501.32,814.72)μg/L]in COPD group,the difference between groups was statistically significant(P<0.05).Multivariate logistic regression analysis showed that increased levels of NT-proBNP,CRP and ET-1 were risk factors for COPD complicated with PAH(P<0.05).The area under the curve of the comb
作者
郑院青
李雪
张倩
ZHENG Yuanqing;LI Xue;ZHANG Qian(Department of Respiratory and Critical Care Medicine,Pingmei Shenma Group General Hospital,Pingdingshan,Henan 467000,China)
出处
《安徽医药》
CAS
2023年第10期2033-2037,共5页
Anhui Medical and Pharmaceutical Journal
关键词
肺疾病
慢性阻塞性
肺动脉高压
N末端脑钠肽前体
C-反应蛋白
内皮素-1
Pulmonary disease,chronic obstructive
Pulmonary hypertension
N-terminal pro-brain natriuretic peptide
C-reactive protein
Endothelin-1
