慢性阻塞性肺疾病患者血清C-反应蛋白和内皮素-1水平与慢性肺源性心脏病的关系

RELATIONSHIP BETWEEN C-REACTIVE PROTEIN,ENDOTHELIN-1 LEVELS AND CHRONIC COR PULMONALE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

目的探讨慢性阻塞性肺疾病(COPD)患者血清C-反应蛋白(CRP)和内皮素-1(ET-1)水平与慢性肺源性心脏病(chronic cor pulmonale,CCP)的关系。方法检测110例COPD患者外周血血清CRP和ET-1水平,并同期完善心电图、胸部正位X线片、心脏彩色多普勒超声。结果 110例COPD患者中有60例存在CCP,50例未发现CCP。CCP患者血清CRP和ET-1水平均明显高于无CCP患者(P<0.05);COPD患者血清ET-1水平与CRP水平呈显著正相关(r=0.705,P<0.01);COPD患者CCP与血清CRP和ET-1水平呈显著正相关(r=0.462,0.532,P<0.01)。结论 COPD患者血清CRP和ET-1水平与CCP有相关性,CRP和ET-1可能参与了COPD患者CCP的发生发展过程,系统性炎症可能参与COPD继发CCP的发病机制。

Objective To investigate the correlation between C- reactive protein（ CRP）, endothelin- 1（ ET-1） levels and chronic cor pulmonale （CCP） in patients with chronic obstructive pulmonary disease （COPD）. Methods Serum CRP and ET- 1 levels of peripheral blood from 110 patients with COPD were detected; meanwhile Electrocardiogram, Chest X- ray, the heart color doppler ultrasound were measured. Results Among 110 cases, CCP was present in 60 cases, and was absent in other 50 cases. Serum CRP and ET-1 levels were significantly higher in patients with CCP than those in patients without CCP（P〈0. 05） ; there were significant positive correlations between the serum ET- 1 level and CRP level in patients with COPD（r = 0. 705,P〈0.01）; there were also significant positive correlations between CCP and the levels of serum ET- 1 and CRP in patients with COPD（r = 0. 462, 0. 532, P〈0. 01）. Conclusion CRP and ET- 1 level is correlate to CCP in patients with COPD. CRP and ET- 1 may play a role in the patho- genesis of CCP in patients with COPD, and systemic inflammation may play a role in the pathogenesis of CCP secondary to COPD patients.