慢性阻塞性肺疾病肺动脉高压与超敏C反应蛋白及氧分压的相关性研究

目的探讨慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）急性加重期（AECOPD）患者C反应蛋白、氧分压与肺动脉收缩压之间的关系。方法将100例AECOPD患者（实验组）分为肺动脉高压组（50例）和肺动脉压正常组（50例）,测定两组患者血清C反应蛋白（CRP）和动脉血氧分压（PO2）水平,并与40例健康志愿者（对照组）比较。结果肺动脉高压组与肺动脉压正常组CRP水平均显著高于正常对照组（40.44±14.35）mg/L、（12.29±4.63）mg/L VS（2.52±0.88）mg/L,均P〈0.05],且肺动脉高压组血清CRP水平显著高于肺动脉压正常组（40.44±14.35）mg/L VS（12.29±4.63）mg/L,P〈0.05]。肺动脉高压组PO2水平显著低于肺动脉压正常组（65.72±7.17）mmHg VS（82.6±6.08）mmHg,P〈0.05]。血清CRP水平与SPAP呈正相关（r=0.68,P〈0.05）,PO2与SPAP呈负相关（r=-0.64,P〈0.05）。结论 COPD患者的肺动脉压力增加与血清CRP水平增高及氧分压降低密切相关,系统性炎症和低氧可能在COPD继发肺动脉高压发病中起一定作用。

Correlation between C-reactive Obstructive Pulmonary Disease Protein,Hypoxia and Chronic with Pulmonary Hypertension

Objective To analyze the relationship between CRP,hypoxemia and pulmonary hypertension in patients with AECOPD.Methods 100 cases of AECOPD patients（experimental group） were divided into groups of pulmonary hypertension（50 cases） and normal pulmonary artery pressure（50 cases）,two groups of patients were measured by serum c-reactive protein（CRP） and arterial partial pressure of oxygen（PO2）,compared with the control group（40 cases）.Results CRP levels of pulmonary hypertension group and without pulmonary hypertension group were significantly higher than the control group （40.44±14.35） mg/L,（12.29±4.63） mg/L vs（2.52±0.88） mg/L,both P〈0.05].In the patients with pulmonary hypertension,serum CRP levels were significantly higher than those in the patients without hypertension （40.44±14.35） mg/L vs（12.29±4.63） mg/L,P〈0.05].PO2 levels of pulmonary hypertension group were significantly lower than normal pulmonary artery pressure （65.72±7.17） mmHg vs（82.6±6.08） mmHg,P〈0.05].There’s a positive correlation between serum CRP level and the SPAP（r=0.68,P〈0.05） and PO2 was negatively correlated with SPAP（r=-0.64,P〈0.05）.Conclusion The increases in SPAP in patients with COPD are closely associated with higher levels of CRP and lower levels of PO2.The systemic inflammation and hypoxemia may play a role in pathogenesis of pulmonary hypertension secondary to COPD patients.