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目的分析缺血修饰白蛋白(IMA)和N末端B型脑钠肽前体(NT-proBNP)对慢性阻塞性肺疾病(COPD)合并肺源性心脏病患者的诊断及预后判断意义。方法收集COPD合并肺源性心脏病组121例,COPD稳定组92例。均在入院24 h内检测两组的白细胞(WBC)、血小板(PLT)、血红蛋白(Hb)、C-反应蛋白(CRP)、血肌酐(SCr)、血浆白蛋白(ALB)、IMA及NT-proBNP的浓度;再根据浓度中位值分为低浓度和高浓度,分析指标浓度与COPD合并肺源性心脏病患者死亡率的关系。结果 COPD合并肺源性心脏病组的PCT、IMA及NT-proBNP水平显著高于COPD稳定期组;ALB水平显著低于COPD稳定期组;低浓度的IMA及NT-proBNP患者病死率均分别显著低于高浓度患者的病死率;上述差异均有统计学意义(P<0.05)。结论 IMA和NT-proBNP浓度有助于COPD合并肺源性心脏病患者病情诊断及预后的判断。
Objective To evaluate the diagnostic and prognostic significance of IMA and N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with chronic obstructive pulmonary disease (COPD) complicated with pulmonary heart disease. Methods 121 COPD patients with pulmonary heart disease and 92 stable COPD patients were collected. (WBC), platelet (PLT), hemoglobin (Hb), C-reactive protein (CRP), serum creatinine (SCr), serum albumin (ALB), IMA and NT- proBNP concentration; then according to the median concentration is divided into low concentration and high concentration, analysis of indicators concentration and COPD patients with pulmonary heart disease mortality. Results The levels of PCT, IMA and NT-proBNP in patients with COPD complicated with cor pulmonale were significantly higher than those in stable COPD patients. The levels of ALB in patients with COPD and COPD were significantly lower than those in patients with stable COPD. The mortality rates of IMA and NT-proBNP were significantly lower Which was lower than that of high concentration patients (all P <0.05). Conclusions The concentration of IMA and NT-proBNP contribute to the diagnosis and prognosis of COPD patients with pulmonary heart disease.