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目的:探讨慢性阻塞性肺病(COPD)急性加重合并肺动脉高压患者C反应蛋白(CRP)、脑钠肽(BNP)、乳酸脱氢酶(LDH)的水平变化和临床意义。方法:收集航天中心医院呼吸科2014年2月至2015年2月收治的COPD急性加重(AECOPD)住院患者共73例,心脏超声测定肺动脉压力,测定血清CRP、BNP、LDH、Pa O2水平。结果:73例中31例伴有肺动脉高压,为肺动脉高压组,42例肺动脉压正常,为肺动脉压正常组。肺动脉高压组血浆CRP;中位55.4mg/L(1.0~200.0mg/L)、BNP;中位131.4pg/ml(16.0~465.0pg/ml)、LDH;中位235.4IU/L(132.1~347.0IU/L)浓度水平明显高于肺动脉正常组CRP;中位24.6mg/L(1.0~145.0mg/L)、BNP;中位42.2pg/ml(10.0~112.0pg/ml)、LDH;中位188.3IU/L(110.6~289.8IU/L)浓度水平,肺动脉高压组的CRP、BNP、LDH与心功能分级呈正相关(r=0.728,0.823,0.854,P<0.01),Pa O2水平与心功能分级则呈负相关(r=-0.606,P<0.01)。结论:COPD并肺动脉高压患者血清CRP、BNP、LDH水平明显升高,与病情严重程度呈明显的相关性,监测血清CRP、BNP、LDH水平可作为临床评估COPD并肺动脉高压病情评估的重要指标。
Objective: To investigate the changes and clinical significance of C-reactive protein (CRP), brain natriuretic peptide (BNP) and lactate dehydrogenase (LDH) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) and pulmonary hypertension. Methods: A total of 73 hospitalized patients with acute exacerbation of COPD (AECOPD) were enrolled in the Respiratory Department of the Space Central Hospital from February 2014 to February 2015. Cardiac arterial pressure was measured by echocardiography. Serum levels of CRP, BNP, LDH and Pa were measured. Results: Of the 73 cases, 31 cases had pulmonary hypertension, pulmonary hypertension group, 42 cases of normal pulmonary hypertension and normal pulmonary hypertension group. Plasma CRP levels in the pulmonary hypertension group were 55.4 mg / L (1.0-200.0 mg / L), BNP, 131.4 pg / ml (16.0- 465.0 pg / ml), LDH, and 235.4 IU / IU / L) was significantly higher than that of the normal pulmonary artery group (median 24.6 mg / L (1.0 ~ 145.0 mg / L), BNP, median 42.2 pg / ml The levels of CRP, BNP and LDH in pulmonary arterial hypertension group were positively correlated with the level of cardiac function (r = 0.728,0.823,0.854, P <0.01) at the concentration of 188.3 IU / L (110.6-289.8 IU / L) Grade was negatively correlated (r = -0.606, P <0.01). CONCLUSIONS: Serum levels of CRP, BNP and LDH are significantly elevated in patients with COPD and pulmonary hypertension, and are significantly correlated with the severity of the disease. Monitoring serum levels of CRP, BNP and LDH can be used as an important index for clinical assessment of COPD and pulmonary hypertension.