慢性阻塞性肺疾病肺动脉高压患者血清利钠肽活化酶与利钠肽的测定及临床意义

Determination and clinical significance of serum corin and natriuretic peptide in the patients of pulmonary hypertension due to chronic obstructive pulmonary disease

目的:探讨慢性阻塞性肺疾病(COPD)肺动脉高压患者中血清利钠肽活化酶(corin)、心钠素前体(proANP),心钠素(ANP)、NT-proBNP的水平变化和临床意义。方法:纳入COPD患者102例,其中COPD无肺动脉高压组50例(I组);COPD肺动脉高压组52例(II组);健康对照组45例(III组),ELISA法检测五组患者血清corin、proANP,ANP、NT-proBNP水平、超声心动图测定肺动脉压力,血气分析检测动脉血氧分压。结果:COPD肺动脉高压患者血清corin、动脉血氧分压均低于COPD无肺动脉高压组和健康对照组,且随肺动脉压力升高呈下降趋势,血清corin、Pa0_2水平与sPAP均成负相关(P<0.05);COPD肺动脉高压患者的血清ANP、NT-proBNP水平高于COPD无肺动脉高压组和健康对照组,血清NT-proBNP、ANP与sPAP均成正相关(P<0.05)。结论:血清corin水平的变化可能参与了COPD肺动脉高压的病理生理过程;临床检测血清corin、NT-proBNP、ANP水平对于评估病情严重程度和预后有重要意义。

Objective: To investigate the determination and clinical significance of serum corin, proatrial natriuretic peptide(proANP), atrial natriuretic peptide(ANP), N-terminal probrain natriuretic peptide(NT-proBNP) in pulmonary hypertension due to chronic obstructive pulmonary disease patients(COPD). Methods: Assay the serum corin, proANP, ANP and NT-proBNP levels in COPD(n=102),including 50 patients without pulmonary hypertension(PH)(group I),52 patients with PH(group II),and healthy individuals served as control group(n=45) with enzy melinked immunoso rbent assay(ELISA). Assay arterial partial pressure of oxygen(PaO2) by blood gas analyzer, systolic pulmonary artery pressure(sPAP) by color Doppler ultrasound. Results: The levels of plasma corin、PaO2 in group COPD with PH were significantly lower than control group and group COPD without PH, and a downward trend with increased sPAP, using Spearma correlation analysis, Corin、Pa02 were negative related to sPAP(P<0.05). The levels of plasma NT-proBNP, ANP in group COPD with PH were significantly higher than control group and group COPD without PH, using Spearma correlation analysis, plasma NT-proBNP, ANP were positive to sPAP(P<0.05). Conclusions: The serum corin level in blood may be involved in the pathological processes of pulmonary hypertension;Clinical detection of plasma corin,NT-proBNP, ANP level may be as a parameter in evaluating the severity and prognosis of disease.