特发性肺动脉高压患者RDW、NT-ProBNP、BigET-1、HMGB1水平变化及临床意义

目的 探讨特发性肺动脉高压(IPAH)患者红细胞分布宽度(RDW)、N-端脑钠肽前体(NT-proBNP)、大内皮素-1(BigET-1)以及高迁移率组蛋白B1(HMGB1)的变化及临床意义。方法 选取我院2019年11月至2020年10月收治的IPAH患者80例为观察组,另选取同期在我院体检的健康人80例为对照组,对比两组RDW、NT-proBNP、BigET-1、HMGB1以及超声心动图指标,并分析上述指标的相关性。结果 观察组RDW、NT-proBNP、BigET-1、HMGB1均高于对照组(均P<0.01);左心室舒张末期内径(LVEDD小于对照组(P<0.01);RVEDD大于对照组(P<0.01)。相关分析表明,IPAH患者RDW、NT-proBNP、BigET-1、HMGB1与LVEDD、左心室射血分数(LVEF)、心脏指数(CI)呈负相关,与RVEDD呈正相关;NT-proBNP、HMGB1均与肺动脉平均压(PAMP)、肺血管阻力(PVR)呈正相关(P<0.05)。结论 RDW、NT-proBNP、BigET-1、HMGB1水平在IPAH患者中明显升高,且与LVEDD、PAMP、PVR等指标相关,可作为诊断与评估IPAH病情的参考指标。

Levels and clinical significance of RDW,NT-proBNP,BigET-1, HMGB1 in patients with idiopathic pulmonary arterial hypertension

Objective To explore the changes and clinical significance of red blood cell distribution width(RDW), N-terminal pro-brain natriuretic peptide(NT-proBNP), big endothelin-1(BigET-1), high mobility group protein-B1(HMGB1) in patients with idiopathic pulmonary arterial hypertension(IPAH).Methods Totally 80 IPAH patients admitted to our hospital from Nov 2019 to Oct 2020 were enrolled as the observation group,the control group comprised 80 healthy volunteers undergoing physical examination in our hospital during the same period; the aim was to compare RDW, NT-proBNP, BigET-1, HMGB1 as well as echocardiogram indexes between groups; and the correlation of the above indicators was analyzed. Results Compared with control group, RDW, NT-proBNP, BigET-1, HMGB1 in observation group were significantly higher (all P<0.01), left ventricular end diastolic dimension(LVEDD) was notably smaller (P<0.01), right ventricular end diastolic diameter(RVEDD) was significantly larger (P<0.01). Correlation analysis showed that RDW, NT-proBNP, BigET-1, HMGB1 were negatively correlated with LVEDD, left ventricle ejection fraction(LVEF), cardiac index(CI), while positively correlated with RVEDD. Positive correlation existed between NT-proBNP, HMGB1 and pulmonary artery mean pressure(PAMP), pulmonary vascular resistance(PVR)(P<0.05).Conclusion RDW, Nt-proBNP, BigET-1, HMGB1 in IPAH patients are increased, and the indexes are related to LVEDD, PAMP, PVR, and those can be used as references for diagnosis and evaluation of IPAH.