| 郑院青,李雪,张倩.内皮素 -1、C反应蛋白和 N-末端脑钠肽前体在慢性阻塞性肺疾病合并肺动脉高压病人中的表达水平及临床价值[J].安徽医药,2023,27(10):2033-2037. |
| 内皮素 -1、C反应蛋白和 N-末端脑钠肽前体在慢性阻塞性肺疾病合并肺动脉高压病人中的表达水平及临床价值 |
| Expression levels and clinical value of endothelin-1, C-reactive protein and N-terminal pro-brain natriuretic peptide in patients with chronic obstructive pulmonary disease and pulmonary hypertension |
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| DOI：10.3969/j.issn.1009-6469.2023.10.027 |
| 中文关键词: 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 |
| 英文关键词: Pulmonary disease, chronic obstructive Pulmonary hypertension N-terminal pro-brain natriuretic peptide C-reactive protein Endothelin-1 |
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| 中文摘要: |
| 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(184.20，1 460.36)ng/L］、 CRP［( 45.47(30.47，78.21)mg/L］和 ET-1［1 425.25(726.41，1 820.14)μg/L］，高于 COPD组［ 523.25(184.20，1 460.36)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。 |
| 英文摘要: |
| 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 whowere treated in Pingmei Shenma Group General Hospital from October 2018 to October 2021 were enrolled. The patients were assignedinto COPD group (n=72) and COPD complicated with PAH group (n=42), according to whether they were complicated with PAH. Theautomatic 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 wasused 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, 1 460.36)n g/L], CRP [45.47 (30.47, 78.21) mg/L] and ET-1 [1 425.25 (726.41, 1 820.14) 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 statisticallysignificant (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 combined detection of NT-proBNP, CRP and ET-1 for predicting COPD complicated with PAH was 0.92, which was greater than the 0.77, 0.78 and 0.86 of the single detection of NT-proBNP, CRP and ET-1(Z=6.25, 5.96, 3.96, all P<0.05).Conclusion Increased levels of NT-proBNP, CRP and ET-1 are independent riskfactors for COPD combined with PAH, and the combined clinical value of predicting COPD combined with PAH is higher than that ofsingle detection. |
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