COPD并肺心病心力衰竭hs-CRP、BNP检测临床意义分析

目的探讨COPD并肺心病心力衰竭患者超敏C反应蛋白（hs—CRP）及脑纳肽（BNP）临床水平变化意义。方法测量COPD并肺心病心力衰竭患者组55例及门诊健康体检组30例血清hs—CRP、BNP水平，按照美国纽约心脏病协会分级方案对COPD并肺心病心力衰竭患者组55例分组。结果COPD并肺心病患者组hs—CRP、BNP水平明显高于对照组（P〈0．05），心力衰竭分组hs—CRP、BNP水平随心衰分级明显升高，Ⅳ级组明显高于I级组，Pa02水平随心衰分级逐步下降，各组之间两两比较均有统计学意义（P〈0．05）。相关性分析显示慢性阻塞性肺病（COPD）并肺心病心力衰竭患hs—CRP、BNP与心衰分级呈正相关（r=0．384，0．280，P〈005），Pa02水平与心衰分级呈负相关（r=-0．251，P〈0．05）。结论COPD并肺心病心力衰竭组患者hs—CRP、BNP水平明显升高，监测hs—CRP、BNP水平可作为临床评估肺心病心力衰竭预后指标。

Clinical significance of the monitoring of hs-CRP and BNP levels in patients with COPD complicated with chronic pulmonary heart disease and heart failure

Objective To investigate the change of hs-CRP and BNP levels and their clinical significances in patients with COPD complicated with chronic pulmonary heart disease and heart failure. Methods The levels of hs-CRP and BNP were measured in 55 patients with COPD complicated with chronic pulmonary heart disease and heart failure and 30 healthy peopie as the controls, and the pa- tients were classified into different grades according to the levels of hs-CRP and BNP. Results. The levels of hs-CRP and BNP were obvi- ously higher in the patients group than in the controls （P 〈 0. 05）. The concentrations of BNP and hs-CRP increased gradually with the high grade, but the PaO2 levels decreased gradually. There was a negative correlation between PaO2 and NYHA class （r = -0. 251, P 〈 0. 05）. Conclusion The levels of hs-CRP and BNP are obviously higher than the normal value. Therefore, the monitoring of hs-CRP and BNP levels can provide reliable indicators for the diagnosis of patients with COPD combined with chronic pulmonary disease and heart failure.