贵州医科大学学报

2017, v.42;No.204(09) 1076-1080

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PCT BNP Hs-CRP及D-D联合检测在AECOPD伴PH中的价值
The Value of Combined Detection of PCT,BNP,Hs-CRP,and D-D in Early Diagnosis and Prognosis of AECOPD Accompanied by PH

李艳;
LI Yan;Chengdu Xindu District People's Hospital;

摘要(Abstract):

目的:探讨联合检测降钙素原(PCT)、脑尿钠肽(BNP)、超敏C-反应蛋白(hs-CRP)及D-二聚体(DD)在慢性阻塞性肺疾病急性加重(AECOPD)伴肺动脉高压(PH)早期识别、病情预后中的评估价值。方法:180例AECOPD患者,根据是否伴PH及AECOPD严重程度分为无PH组、轻度PH组、中度PH组、重度PH组及极重度PH组,比较入院时5组患者血清hs-CRP、D-D、NT-pro BNP及PCT水平,比较5组患者治疗后病情恢复至稳定期的比例;同时比较伴PH的AECOPD患者治疗后恢复至稳定期或死亡病例血清NT-pro BNP、Hs-CRP、PCT及D-D水平。结果:伴PH组患者入院时NT-pro BNP、Hs-CRP、PCT及D-D水平明显高于无PH组患者,随着PH严重程度的加重,患者的NT-pro BNP、Hs-CRP、PCT及D-D水平逐渐增高(P<0.05);无PH的AECOPD患者病情恢复至稳定期的比例明显高于伴PH组,轻度伴PH的AECOPD患者恢复至稳定期的比例明显高于重度和极重度伴PHAECOPD患者(P<0.05);经治疗后恢复至稳定期伴PH的AECOPD患者NT-pro BNP、Hs-CRP、PCT及D-D水平均明显低于治疗后无效死亡的伴PH患者(P<0.05)。结论:NT-pro BNP、Hs-CRP、PCT及D-D联合检测对早期诊断AECOPD伴PH并评估病情严重程度和预后有一定价值。
Objective: To investigate the effect and value of combined detection of procalcitonin( PCT),N-terminal pro-brain type natriuretic peptide( NT-pro BNP),high sensitivity C-reactive protein( Hs-CRP) and D-dimer( D-D) in early diagnosis and prognosis of acute exacerbation of chronic obstructive pulmonary disease( AECOPD) accompanied by pulmonary hypertension( PH). Methods:A retrospective analysis was conducted on the clinical data of 180 AECOPD patients. According to whether accompanied by PH or not and the severity of PH,the patients were divided into non-,mild-,moderate-,severe-,and extremely severe-PH groups. Serum levels of PCT,NT-pro BNP,Hs-CRP,and D-D of these patients on admission were detected. The ratio of recovery-stabe phase after treatment of the 5 groups were compared. As well,serum levels of PCT,NT-pro BNP,Hs-CRP,and D-D of patients with HP during recovery-stable phase were compared among groups and compared with those cases of death. Results: Serum levels of PCT,NT-pro BNP,Hs-CRP,and D-D of AECOPD patients in PH groups were significantly higher than those of patients in group non-PH,and the levels increased along with the increase of PH severity( P < 0. 05). The ratio of recovery-stable phase in non-PH group was markedly higher than those in PH groups. The ratio of recovery-stable phase in group mild-PH wasmarkedly higer than those in groups sever-PH and extremely severe-PH( P < 0. 05). Serum levels of PCT,NT-pro BNP,Hs-CRP,and D-D of AECOPD patients in PH groups that recovered to stable phase were significantly lower than before treatment,and lower than those death cases. Conclusions:The joint detection of NT-pro BNP,Hs-CRP,PCT,D-D is to some extent valuable in early diagnosis,and identification of AECOPD with PH,and in assessing the severity and prognosis of the disease.

关键词(KeyWords): 慢性阻塞性肺疾病急性加重期;肺动脉高压;降钙素原;脑钠肽;C-反应蛋白;D-二聚体
acute exacerbation of chronic obstructive pulmonary disease;pulmonary hypertension;procalcitonin;brain natriuretic peptide;C-reactive protein;D-dimer

Abstract:

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基金项目(Foundation):

作者(Author): 李艳;
LI Yan;Chengdu Xindu District People's Hospital;

Email:

DOI: 10.19367/j.cnki.1000-2707.2017.09.018

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