SCOPD合并SAP患者心肺有关标志物及炎症因子观察

Cardiopulmonary Relevant Markers and Inflammatory Factors in Patients with Stable Chronic Obstructive Pulmonary Disease Complicated with Stable Angina Pactoris

目的研究稳定期慢性阻塞性肺病(SCOPD)合并稳定性心绞痛(SAP)患者血清心肺有关标志物特征与关联。方法选择SCOPD合并SAP患者242例(合并组)、SCOPD患者60例(SCOPD组)、健康体检者30名(健康组)。采集受试者一般资料,采空腹静脉血检测N端脑钠肽前体(NT-proBNP)、c Tn I、Clara细胞分泌蛋白(CC16)、表面活性蛋白-D(SP-D)、白介素-1β(IL-1β)、白介素-10(IL-10)及C反应蛋白(CRP),并行肺功能检测,比较上述指标的差异,并在SCOPD组及合并组患者中进行亚组分析,对合并组上述标志物进行线性相关分析。结果与健康组比较,两个患者组NT-pro-BNP、c Tn I、SP-D、IL-1β及CRP升高(P<0.05),SCOPD组低于合并组(P<0.05);而CC16和IL-10降低(P<0.05),合并组低于SCOPD组(P<0.05)。亚组分析显示大部分指标亦随病情加重而波动。合并组血清NT-pro-BNP、c Tn I与CC16呈负相关(P<0.01),与SP-D呈正相关(P<0.01);心肺有关标志物与部分炎症标志物相关(P<0.01)。结论 SCOPD合并SAP患者较SCOPD患者心肺损伤严重,炎症可能是其重要机制,且心肺有关标志物之间具有相关性。

Objective To investigate the distribution and relevance of cardiopulmonary involved markers in patients with stable chronic obstructive pulmonary disease（ SCOPD） complicated with stable angina pectoris（ SAP）. Methods Serum biomarkers of NT-pro-BNP,cTnI,surfactant protein D（ SPD）,CC1 6,IL-1 β,IL-10and CRP were measured in 242 patients with SCOPD complicated with SAP（ complication group） and 60patients with SCOPD（ SCOPD group）,as well as 30healthy subjects（ healthy group）. Pulmonary function was also tested on each subjects. The differences of indices mentioned above were compared among the 3 groups,furthermore subgroup analyses were carried out in SCOPD group and complication group,and linear correlation was performed in the latter. Results Compared with healthy group,serum concentration of NT-pro-BNP,cTnI,SP-D,IL-1 β and CRP in the two case groups were in-creased（ P 0.05）,and those in the SCOPD group were lower than the complication group（ P 0.05）.Furthermore,the CC1 6 and IL-10concentration were decreased（ P 0.05）,and those in complication group were lower than SCOPD group（ P 0.05）. Subset analyses showed most of the markers fluctuated with the disease severity. Serum concentrations of NT-pro-BNP and cTnI in complication group were negatively associated with CC1 6（ P 0.01）,and positively associated with SP-D（ P 0.01）. Furthermore,the cardiopulmonary relevant markers were correlated with partial inflammatory factors（ P 0.01）. Conclusions The injury of heart and lung are aggravated in patients with SCOPD complicated with SAP than in SCOPD,inflammation may play a central role in the pathogenesis,and cardiopulmonary markers correlate with each other.