Abstract：【Objective】To explore the predictive value of right ventricular myocardial performance index (RVMPI) combined with N-terminal pro-brain natriuretic peptide (NT-proBNP) for chronic obstructive pulmonary disease (COPD)-associated pulmonary arterial hypertension (PH).【Methods】NT-proBNP, RVMPI, and pulmonary artery systolic pressure (PASP) levels were measured in 144 COPD patients within 24 hours of admission and PASP levels were reassessed after one month of treatment. Patients were divided into a PH group and a normal pulmonary artery group based on their PASP levels. Logistic multivariate regression was used to identify factors associated with secondary PH, and receiver operating characteristic (ROC) curves were used to assess the predictive value of RVMPI and NT-proBNP for secondary PH.【Results】 Of the 144 patients, 49 had PH (34.03%) and 95 had normal pulmonary artery pressure (65.97%). The PH group had a higher proportion of smoking history, Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) scores, NT-proBNP level, and RVMPI level compared to the normal group, while their 6-minute walk distance(6MWD) distance and FEV1/FVC levels were lower (P<0.05). Multivariate regression analysis showed that smoking history, lower 6MWD distance, higher APACHE Ⅱ scores, elevated NT-proBNP level, and increased RVMPI were associated with secondary PH in COPD patients (P<0.05). ROC analysis indicated that the area under the curve (AUC) for predicting secondary PH using NT-proBNP, RVMPI, and their combination were 0.764, 0.746, and 0.854, respectively, with the combined prediction being superior to either alone (P<0.05).【Conclusion】 COPD patients with secondary PH have elevated NT-proBNP and RVMPI levels, and both markers provide high predictive efficacy for PH.
杨梦鸿, 辛阿欢. 右室心肌工作指数联合NT-proBNP预测COPD相关性肺动脉高压的效能分析[J]. 医学临床研究, 2024, 41(12): 1852-1855.
YANG Menghong, XIN Ahuan. Predictive Value of Right Ventricular Myocardial Perfomance Index Combined with NT-proBNP in COPD Associated Pulmonary Arterial Hypertension. JOURNAL OF CLINICAL RESEARCH, 2024, 41(12): 1852-1855.
[1] LABAKI W W, ROSENBERG S R. Chronic obstructive pulmonary disease[J].Ann Intern Med,2020,173(3):C17-C32.
[2] DUFFY S P, CRINER G J. Chronic obstructive pulmonary disease: evaluation and management[J].Med Clin North Am,2019,103(3):453-461.
[3] 任雯,张璋,杨帆,等. 心脏磁共振心功能指标评估肺动脉高压患者预后的价值[J].第二军医大学学报,2019,40(3):262.
[4] 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.
[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].中国医学前沿杂志(电子版),2014(2):67-79.
[6] VARMAGHANI M, DEHGHANI M, HEIDARI E, et al. Global prevalence of chronic obstructive pulmonary disease: systematic review and meta-analysis[J].East Mediterr Health J,2019,25(1):47-57.
[7] 宋雨,马丽娜,杨媛华. 基于聚类分析法探讨肺动脉压力在慢性阻塞性肺疾病表型及预后评估中的作用[J].中华医学杂志,2020,100(2):97-103.
[8] 孙芸,陆士奇,屠苏,等. 血液标志物和心脏彩超检查在慢性阻塞性肺疾病急性加重期相关性肺动脉高压的评估价值[J].中国急救医学,2019,39(11):1058-1064.
[9] 陈妤,梁世廉,黄献欢,等. COPD合并肺动脉高压患者NLR、MSTN、TXB2、NT-proBNP的变化及其意义[J].解放军预防医学杂志,2019,37(4):55-56.
[10] 冯长明,王成健,李银鹏. 心脏MRI评估COPD患者肺动脉血流和右心功能的临床研究[J].重庆医学,2020,49(22):3768-3771.
[11] KILIC I D, UGURLU E, SEVGICAN C I, et al. The effects of endobronchial coil therapy on right ventricular functions[J].COPD,2020,17(6):699-705.
[12] OAKES J M, XU J, MORRIS T M, et al. Effects of chronic nicotine inhalation on systemic and pulmonary blood pressure and right ventricular remodeling in mice[J].Hypertension,2020,75(5):1305-1314.
[13] RITCHIE A I, WEDZICHA J A. Definition, causes, pathogenesis, and consequences of chronic obstructive pulmonary disease exacerbations[J].Clin Chest Med,2020,41(3):421.
[14] BLANCO I, TURA-CEIDE O, PEINADO V I, et al. Updated perspectives on pulmonary hypertension in COPD[J].Int J Chron Obstruct Pulmon Dis,2020,15(1):1315-1324.
[15] RILEY C M, SCIURBA F C. Diagnosis and outpatient management of chronic obstructive pulmonary disease: a review[J].JAMA,2019,321(8):786-797.
2024, Vol. 41 
