氨基末端脑钠肽前体、胱抑素C和超敏C反应蛋白评估慢性阻塞性肺疾病合并肺部感染预后的价值分析

摘要
图/表
参考文献(22)
相关文章 (15)

全文: PDF (0 KB) HTML (35 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨氨基末端脑钠肽前体（NT-proBNP）、胱抑素C（Cys C）和超敏C 反应蛋白（hs-CRP）联合检测在评估慢性阻塞性肺疾病（COPD）合并肺部感染预后中的应用价值。方法选取2017年1月至2020年3月辽宁省健康产业集团抚矿总医院收治的170 例COPD 患者作为研究对象，根据是否发生肺部感染将其分为感染组（80 例）和非感染组（90 例），根据住院期间（7～14 d）预后情况将感染组分为死亡组（9 例）和非死亡组（71 例），同时选取50 例健康体检者作为对照组。检测所有受试者的血清NT-proBNP、Cys C 和hs-CRP 水平，比较NT-proBNP、Cys C和hs-CRP 单独及联合检测在COPD 合并肺部感染中的诊断价值。结果感染组患者的血清NT-proBNP、Cys C 和hs-CRP 水平高于非感染组和对照组，差异有统计学意义（P＜0.05）；非感染组患者的血清NT-proBNP、Cys C 和hs-CRP 水平高于对照组，差异有统计学意义（P＜0.05）。死亡组患者的血清NT-proBNP、Cys C 和hs-CRP 水平高于非死亡组，差异有统计学意义（P＜0.05）。三项指标联合评估COPD 合并肺部感染预后的曲线下面积（AUC）高于单一指标，差异有统计学意义（P＜0.01）。结论血清NT-proBNP、Cys C 和hs-CRP 水平在COPD 合并肺部感染中，随病情进展逐渐升高，联合检测对评估预后具有较高的临床价值。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	于欣
	董南君
	何廉旗

关键词 ：氨基末端脑钠肽前体, 胱抑素C, 超敏C 反应蛋白, 慢性阻塞性肺疾病, 肺部感染

Abstract：Objective To explore the clinical application value of combined detection of N-terminal pro-brain natriuretic peptide (NT-proBNP), cystatin C (Cys C) and high-sensitivity C-reactive protein (hs-CRP) in evaluating the prognosis of chronic obstructive pulmonary disease (COPD) complicated with lung infection. Methods A total of 170 COPD patients admitted to General Hospital of Fushun Mining Bureau of Liaoning Health Industry Group from January 2017 to March 2020 were selected as the research objects. According to the occurrence of pulmonary infection, they were divided into infection group (80 cases) and non-infection group (90 cases). According to the prognosis during hospitalization (7-14 days), the infection group was divided into death group (9 cases) and non-death group (71 cases),and 50 healthy subjects were selected as the control group. The serum levels of NT-probNP, Cys C and hs-CRP of all subjects were detected, and the diagnostic value of NT-proBNP, Cys C and hs-CRP alone and in combination in COPD with pulmonary infection was compared. Results The serum levels of NT-proBNP, Cys C and hs-CRP in infected group were higher than those in non-infected group and control group, and the differences were statistically significant (P＜0.05). The serum levels of NT-proBNP, Cys C and hs-CRP in non-infected group were higher than those in control group, and the differences were statistically significant (P＜0.05). The serum levels of NT-proBNP, Cys C and hs-CRP in the death group were higher than those in the non-death group, and the differences were statistically significant (P＜0.05). The area under the curve (AUC) of three indicators combined to evaluate the prognosis of COPD combined with pulmonary infection was higher than that of single indicator, and the difference was statistically significant (P＜0.01). Conclusion Serum NT-proBNP, Cys C and hs-CRP levels in COPD complicated with pulmonary infection gradually increase with the progression of the disease,and combined detection has a high clinical value in evaluating the prognosis.

Key words： N-terminal pro-brain natriuretic peptide Cystatin C Hypersensitive C-reactive protein Chronic obstructive pulmonary disease Lung infection

基金资助:辽宁省自然科学基金博士启动基金资助项目（2020-BS-284）。

引用本文:

于欣；董南君；何廉旗. 氨基末端脑钠肽前体、胱抑素C和超敏C反应蛋白评估慢性阻塞性肺疾病合并肺部感染预后的价值分析[J]. 中国当代医药, 2021, 28(30): 157-160.
YU Xin；DONG Nan-jun；HE Lian-qi. Value analysis of N-terminal pro-brain natriuretic peptide, cystatin C and hypersensitive C -reactive protein in evaluating the prognosis of chronic obstructive pulmonary disease with pulmonary infection. 中国当代医药, 2021, 28(30): 157-160.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I30/157

[1]	Vogelmeier CF，Criner GJ，Martinez FJ，et al.Global Strategy for the Diagnosis，Management，and Prevention of Chronic Obstructive Lung Disease 2017 Report.GOLD Executive Summary[J].Am J Respir Crit Care Med，2017，195（5）：557-582.
[2]	Hendrickson CM，Kwong YD，Belzer AG，et al.Higher plasma cystatin C is associated with mortality after acute respiratory distress syndrome：findings from a Fluid and Catheter Treatment Trial （FACTT）substudy[J].Crit Care，2020，24（1）：416.
[3]	Edwards KD，Tighe MP.How to use N-terminal pro-brain natriuretic peptide （NT-proBNP）in assessing disease severity in bronchiolitis[J].Arch Dis Child Educ Pract Ed，2020，105（5）：282-288.
[4]	Sproston NR，Ashworth JJ.Role of C-Reactive Protein at Sites of Inflammation and Infection[J].Front Immunol，2018，9：754.
[5]	中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南（2013年修订版）[J].中华结核和呼吸杂志，2013（4）：255-264，3.
[6]	中华人民共和国卫生部.医院感染诊断标准（试行）[J].中华医学杂志，2001（5）：61-67.
[7]	López -Campos JL，Tan W，Soriano JB.Global burden of COPD[J].Respirology，2016，21（1）：14-23.
[8]	武红莉，田瑞雪，宁兰丁，等.慢性阻塞性肺疾病患者肺部感染的影响因素分析及血清炎症因子水平变化分析[J].中华医院感染学杂志，2018，28（1）：25-28.
[9]	周坤，王亚玲，张国茹.血清BNP 水平在心力衰竭分级中的预后及诊断意义[J].中国实验诊断学，2020，24（6）：895-899.
[10]	马爱闻，徐继扬，陈俊，等.N 末端B 型钠尿肽原及心肌肌钙蛋白I 对慢性阻塞性肺疾病合并肺动脉高压患者病情的评估价值[J].实用临床医药杂志，2020，24（7）：16-19.
[11]	Arjamaa O，Nikinmaa M.Hypoxia regulates the natriuretic peptide system[J].Int J Physiol Pathophysiol Pharmacol，2011，3（3）：191-201.
[12]	Arjamaa O.Physiology of natriuretic peptides：The volume overload hypothesis revisited[J].World J Cardiol，2014，6（1）：4-7.
[13]	Labaki WW，Xia M，Murray S，et al.NT-proBNP in stable COPD and future exacerbation risk：Analysis of the SPIROMICS cohort[J].Respir Med，2018，140：87-93
[14]	Pandey KC，De S，Mishra PK.Role of proteases in chronic obstructive pulmonary disease[J].Front Pharmacol，2017，8：512
[15]	Zi M，Xu Y.Involvement of cystatin C in immunity and apoptosis[J].Immunol Lett，2018，196：80-90.
[16]	陈玉群，肖叶，胡大碧，等.血清同型半胱氨酸、胱抑素C水平对COPD 合并呼吸衰竭患者预后的影响[J].中国煤炭工业医学杂志，2020，23（3）：293-298.
[17]	Turk V，Stoka V，Turk D.Cystatins：biochemical and structural properties，and medical relevance[J].Front Biosci，2008，13：5406-5420.
[18]	Qu J，Yue L，Gao J，et al.Perspectives on Wnt Signal Pathway in the Pathogenesis and Therapeutics of Chronic Obstructive Pulmonary Disease[J].J Pharmacol Exp Ther，2019，369（3）：473-480.
[19]	Chai L，Feng W，Zhai C，et al.The association between cystatin C and COPD：a meta-analysis and systematic review[J].BMC Pulm Med，2020，20（1）：182.
[20]	张巍，朱娅丽，杜维桓，等.老年慢性阻塞性肺疾病急性加重期患者血清hs-CRP、CTRP-9、YKL-40 水平变化及临床意义[J].临床误诊误治，2021，34（3）：52-57.
[21]	李秀业，刘领，薛兵.N-端脑钠肽前体与肿瘤坏死因子-α对慢性阻塞性肺疾病急性加重期及合并全身炎症反应综合征诊断的意义[J].中国医药科学，2021，11（3）：224-227.
[22]	张起，徐艳平，刘伟，等.胱抑素C、脑钠肽前体、降钙素原及超敏C 反应蛋白在阻塞性肺疾病患者加重期中的诊断价值[J].中国现代医生，2020，58（19）：127-130.