慢性阻塞性肺疾病急性加重期C-反应蛋白、D-二聚体与肺动脉高压关系探讨

Relationship between CRP, D-Dimer and pulmonary hypertension in patients with AECOPD

目的探讨慢性阻塞性肺病急性加重期(AECOPD)患者C-反应蛋白、D-二聚体水平与肺动脉收缩压之间的关系。方法检测82例AECOPD患者及30例健康志愿者外周血血清C-反应蛋白、血浆D-二聚体水平,并同期采用超声心动图检测肺动脉收缩压。结果82例AECOPD患者中有41例存在肺动脉高压,另外41例及健康志愿者未发现肺动脉高压。无肺动脉高压组和肺动脉高压组AECOPD患者C-反应蛋白及D-二聚体水平均明显高于对照组(P<0.05);肺动脉高压组C-反应蛋白及D-二聚体水平均明显高于无肺动脉高压组(P<0.05);肺动脉高压组肺动脉收缩压与血清CRP水平呈显著正相关(r=0.384,P<0.05);而与血浆D-二聚体水平无显著相关性(P>0.05)。结论COPD患者存在系统性炎症和血液高凝状态,是导致和加重COPD患者肺动脉高压的重要因素,作为分别体现系统性炎症和血液高凝状态的主要指标,C-反应蛋白和D-二聚体可在一定程度上反映肺动脉收缩压水平。

[Objective] To analyze the relationship between CRP, D-Dimer and Pulmonary Hypertension in Patients with AECOPD. [Methods] Serum CRP and plasma D-Dimer levels of peripheral blood from 82 patients with AECOPD and 30 healthy volunteers were detected; Pulmonary artery pressure levels were measured by echocardiography. [Results] Pulmonary hypertension was present in 41 patients and was absent in other 41 patients and 30 healthy controls. In patients with AECOPD, CRP and D-Dimer levels were signifieandy higher than in healthy controis. CRP and D-Dimer levels were significandy higher in patients with pulmonary hypertension compared to those without. In patients with pulmonary hypertension, a significant positive linear relationship was observed between CRP and systolic pulmonary artery pressure, and was not found between D-Dimer and systolic pulmonary artery pressure. [Conclusion] COPD is associated with systemic inflammation and hypercoagulabale state, which will cause and aggravate pulmonary hypertension. CRP and D-Dimer are the main markers of systemic inflammation and hypercoagulabale state, respectively, and they can reflect the level of systolic pulmonary artery pressure in a way.