慢性阻塞性肺疾病急性加重期血清同型半胱氨酸、D-二聚体、N末端脑钠肽前体和心肌肌钙蛋白的临床意义

Clinical significance of serum homocysteine, D-dimer, N-terminal pro-brain natriuretic peptide and cardiac troponin in acute exacerbation of chronic obstructive pulmonary disease

目的:探讨慢性阻塞性肺疾病急性加重期(AECOPD)血清同型半胱氨酸(Hcy)、D-二聚体、N末端脑钠肽前体(NT-proBNP)及心肌肌钙蛋白(cTnI)的关系及临床意义。方法:收治AECOPD患者60例为AECOPD组,同期健康体检者60例为正常对照组,分别检测AECOPD组治疗前后及正常对照组血Hcy、D-二聚体、NT-proBNP和cTnI水平。结果:AECOPD组治疗前后Hcy、D-二聚体、NT-proBNP和cTnI相比于正常对照组均升高(P<0.05),且AECOPD治疗后Hcy、D-二聚体、NT-proBNP和cTnI水平较治疗前下降(P<0.05)。AECOPD患者血Hcy水平与D-二聚体、NT-proBNP和cTnI分别呈正相关。结论:COPD患者存在高凝状态,易产生肺血管微血栓,引起肺动脉高压,导致心脏损伤。

Objective:To investigate the relationship and clinical significancebetween serum homocysteine (Hcy),D-dimer, N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin (cTnI) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:60 patients with AECOPD were enrolled in the AECOPD group,60 healthy people in the same period were as the normal control group;the levels of Hcy,D-dimer,NT-proBNP and cTnI in blood of AECOPD group before and after the treatment and normal control group were detected.Result:Hcy,D-dimer,NT-proBNP and cTnI were elevated in the AECOPD group before and after the treatment (P<0.05).The level of blood Hcy in patients with AECOPD was positively correlated with D-dimer,NT-proBNP and cTnI, respectively.Conclusion:Hypercoagulable state in patients with COPD, haspulmonary vascular microthrombus,maycausing pulmonary hypertension,thencausing heart damage.