NT-proBNP、ET-1及CGRP水平与老年COPD合并肺心病NYHA心功能分级的相关性

doi:10.3969/j.issn.1671-7171.2023.07.018

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摘要【目的】探讨N末端B型脑钠肽前体(NT-proBNP)、内皮素-1(ET-1)及降钙素基因相关肽(CGRP)水平与老年慢性阻塞性肺疾病(COPD)合并肺心病NYHA心功能分级的相关性。【方法】选取2020年1月至2022年1月在咸阳市第一人民医院诊治的108例老年COPD患者,根据患者是否合并肺心病分为单纯COPD组和COPD合并肺心病组(合并组)。检测所有患者血浆NT-proBNP、ET-1、CGRP水平;采用受试者工作特征(ROC)曲线分析血浆NT-proBNP、ET-1、CGRP水平对COPD合并肺心病的诊断价值;采用Spearman等级相关系数分析COPD合并肺心病患者血浆NT-proBNP、ET-1、CGRP水平与纽约心脏病协会(NYHA)心功能分级的相关性。【结果】与单纯COPD组比较,合并组NT-proBNP、ET-1水平较高,CGRP水平较低(P<0.05); ROC曲线分析结果显示:NT-proBNP、ET-1、CGRP诊断COPD合并肺心病的最佳截断值分别为873.507 pg/mL、117.625 ng/L、33.228 pg/mL;合并组不同NYHA心功能分级患者血浆ET-1、NT-proBNP水平比较,Ⅱ级＜Ⅲ级＜Ⅳ级(均P<0.05);CGRP水平比较,Ⅱ级＞Ⅲ级＞Ⅳ级(均P<0.05);相关性分析结果显示: COPD合并肺心病患者血浆NT-proBNP、ET-1与NYHA心功能分级呈正相关,血浆CGRP水平与NYHA心功能分级呈负相关(P<0.05)。【结论】与单纯COPD组比较,合并组NT-proBNP、ET-1水平较高,CGRP水平较低;COPD合并肺心病患者的NYHA心功能分级与NT-proBNP、ET-1水平呈正相关,与CGRP水平呈负相关。

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	任丹
	雷歆
	张伟强
	王银涛

关键词 ：肺疾病, 慢性阻塞性/并发症, 肺心病/并发症, 利钠肽,脑/血液, 内皮缩血管肽1/血液, 降钙素基因相关肽/血液, 心脏功能试验

Abstract：【Objective】To investigate the correlation between severity of chronic obstructive pulmonary disease (COPD) complicated with pulmonary heart disease and levels of N-terminal B-type brain natriuretic peptide precursor (NT-proBNP), endothelin-1 (ET-1) and calcitonin gene-related peptide (CGRP) in elderly patients. 【Methods】A total of 108 elderly patients with COPD diagnosed and treated in the First People's Hospital of Xianyang City from January 2020 to January 2022 were selected in the study. According to whether the patients were complicated with pulmonary heart disease, they were divided into simple COPD group and COPD complicated with pulmonary heart disease group (combined group).Plasma levels of NT-proBNP, ET-1 and CGRP were detected in all patients. The value of plasma NT-proBNP, ET-1 and CGRP in the diagnosis of COPD complicated with pulmonary heart disease was analyzed by receiver operating characteristic (ROC) curve. Spearman correlation coefficient was used to analyze the correlation of plasma levels of NT-proBNP, ET-1 and CGRP with cardiac function classification of New York Heart Association (NYHA) in elderly COPD patients with pulmonary heart disease. 【Results】Compared with the simple COPD group, the levels of NT-proBNP and ET-1 were higher, while the level of CGRP weas lower in COPD group combined with pulmonary heart disease (P<0.05).ROC analysis showed that the best cutoff values of NT-proBNP, ET-1 and CGRP in the diagnosis of COPD complicated with pulmonary heart disease were 873.507 pg/mL, 117.625 ng/L and 33.228 pg/mL, respectively. In COPD with pulmonary heart disease group, the plasma levels of NT-proBNP and ET-1 in patients with different NYHA cardiac function grades were compared and showed in the order of grade Ⅱ<grade Ⅲ<grade Ⅳ, while CGRP level was opposite grade Ⅱ > grade Ⅲ > grade Ⅳ (P<0.05).Correlation analysis showed that plasma levels of NT-proBNP and ET-1 were positively correlated with NYHA cardiac function grade in COPD patients with pulmonary heart disease, while plasma level of CGRP was negatively correlated with NYHA cardiac function grade (P<0.05). 【Conclusion】Compared to simple COPD, levels of NT-proBNP and ET-1 in COPD patients with pulmonary heart disease were higher, while CGRP level was lower. The degree of cardiac function injury in COPD patients with pulmonary heart disease is positively correlated with the level of NT-proBNP and ET-1, and negatively correlated with the level of CGRP.

Key words： Pulmonary Disease, Chronic Obstructive/CO Pulmonary Heart Disease/CO Natriuretic Peptide, Brain /BL Endothelin-1/BL Calcitonin Gene-Related Peptide/BL Heart Function Tests

收稿日期: 2022-08-15

中图分类号:

R563

引用本文:

任丹, 雷歆, 张伟强, 王银涛. NT-proBNP、ET-1及CGRP水平与老年COPD合并肺心病NYHA心功能分级的相关性[J]. 医学临床研究, 2023, 40(7): 1025-1028.
REN Dan, LEI Xin, ZHANG Wei-qiang, et al. Relationship of COPD Complicated with Pulmonary Heart Disease with Levels of NT-proBNP, ET-1 and CGRP in Elderly Patients. JOURNAL OF CLINICAL RESEARCH, 2023, 40(7): 1025-1028.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.07.018 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I7/1025

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