慢性阻塞性肺疾病急性加重合并急性心力衰竭患者肠黏膜屏障功能变化的临床研究

Clinical Study of Intestinal Mucosal Barrier Function in Patients of Aecopd with Acute Heart Failure

目的探讨慢性阻塞性肺疾病急性加重(acute exacerbation chronic obstructive pulmonary disease,AECOPD)合并急性心力衰竭患者肠黏膜屏障功能的变化,从而评估肠黏膜屏障损害程度与感染程度及病情严重程度的相关性。方法选取AECOPD患者105例,根据是否合并心力衰竭分为单纯AECOPD组(对照组)和AECOPD合并心力衰竭组(心力衰竭组)。入组后,检测入院第1天和第4天的血常规、PCT、hs-CRP、NT-proBNP、血清D-乳酸、DAO水平,分析两组肠黏膜屏障功能变化与血清炎性因子水平及疾病严重程度关系。结果血清D-乳酸、DAO、hs-CRP、NLR水平在心力衰竭组高于对照组,相关分析显示患者血清D-乳酸、DAO与hs-CRP和NLR均呈正相关。结论AECOPD合并急性心力衰竭患者存在严重肠黏膜损害,与感染程度和病情严重程度相关。

Objective To investigate the changes of intestinal mucosal barrier function in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with acute heart failure,and to evaluate the correlation between intestinal mucosal barrier damage and severity of disease.Methods Totally 105 patients with AECOPD were enrolled.According to whether they had heart failure,they were divided into AECOPD group(control group)and AECOPD complicated with acute heart failure group(heart failure group).After the enrollment,all patients was performed to detect the blood routine,PCT,hs-CRP,BNP,serum D-lactic acid and DAO levels on the first and fourth days after admission.The relationship between intestinal mucosal barrier function and disease severity of two group was analyzed.Results The levels of serum D-lactic acid,DAO,hs-CRP and NLR in the heart failure group were higher than those in the control group.Correlation analysis showed that the serum D-lactic acid and DAO were positively correlated with hs-CRP and NLR.Conclusion There was severe intestinal mucosal damage in patients with AECOPD with acute heart failure,and the severity of the disease was related to the degree of infection.