血浆NT-pro BNP和hs-CRP在COPD合并呼吸衰竭中的临床价值

The clinical significance of plasma NT-pro BNP and hs-CRP in prognosis evaluation of patients with COPD complicated by respiratory failure

目的探讨血浆氨基末端脑钠肽前体(NT-pro BNP)和超敏C-反应蛋白(hs-CRP)的表达水平在慢性阻塞性肺病(COPD)合并呼吸衰竭的诊断及预后判断中的意义。方法选取2016年1月至2018年5月急诊科收治的COPD合并呼吸衰竭患者145例,同期收治上呼吸道感染患者106例作为对照组,分析治疗前与治疗后24 h及48 h血浆NT-pro BNP和hs-CRP是否有差异,且分析血浆NT-pro BNP和hs-CRP水平与动脉血气分析及APACHE-Ⅱ评分之间的相关性。结果 COPD合并呼吸衰竭患者血浆NT-pro BNP及hs-CRP水平均显著高于上呼吸道感染患者(P<0.05),NT-pro BNP与动脉血气分析中PaO2及PaCO2存在相关性(P<0.05),而hs-CRP与PaO2、PaCO2及APACHE-Ⅱ评分均呈显著相关性(P<0.05)。治疗24 h后NT-pro BNP和hs-CRP水平显著减低(P<0.05),治疗48 h后hs-CRP进一步减低(P<0.05)。结论血浆NT-pro BNP和hs-CRP在COPD合并呼吸衰竭的诊断、病情严重程度及疾病进展评估方面均具有较好的临床价值。

Objective To investigate the clinical significance of plasma NT-pro BNP and hs-CRP levels in the diagnosis and prognosis evaluation of patients with chronic obstructive pulmonary disease(COPD) complicated by respiratory failure respiratory failure. Methods A total of 145 patients with COPD complicated by respiratory failure who were admitted and treated in our hospital from January 2016 to May 2018 were enrolled as observation group,at the same time, the other 106 patients with upper respiratory tract infection were enrolled as control group. The plasma levels of NT-pro BNP and hs-CRP were dectected and their correlation with arterial blood gas analysis and APACHE-Ⅱ score was analyzed. Moreover the plasma levels of NT-pro BNP and hs-CRP before treatment, at 24 h and 48 h after treatment were detected to evaluate the therapeutic effects. Results The levels of plasma NT-pro BNP and hs-CRP in observation group were significantly higher than those in control group(P<0.05). The plasma NT-pro BNP levels were correlated with those of PaO2 and PaCO2(P<0.05),moreover, the hs-CRP levels were correlated with those of PaO2 and PaCO2 as well as PACHE-Ⅱ scores(P<0.05).At 24 h after treatment the levels of NT-pro BNP and hs-CRP were significantly decreased(P<0.05),moreover, the hs-CRP levels were further decreased at 48 h after treatment(P<0.05). Conclusion The plasma NT-pro BNP and hs-CRP have important clinical significance in the diagnosis and severity evaluation of patients with COPD complicated by respiratory failure.