N-端脑钠肽前体与肿瘤坏死因子-α对慢性阻塞性肺疾病急性加重期及合并全身炎症反应综合征诊断的意义

Significance of N-terminal pro-brain natriuretic peptide and tumor necrosis factor-αin diagnosis of acute exacerbation of chronic obstructive pulmonary disease complicated with systemic inflammatory response syndrome

目的探讨N-端脑钠肽前体(NT-proBNP)及肿瘤坏死因子-α(TNF-α)对于慢性阻塞性肺疾病急性加重期(AECOPD)及合并全身炎症反应综合征(SIRS)患者的诊断意义。方法选取2018年1月1日至2019年12月31日收治北京市垂杨柳医院的患者,依据病历资料选取AECOPD患者(AECOPD组,n=108例),同期同年龄段门诊稳定期COPD患者(稳定期COPD组,n=52)以及健康对照组(n=48),对NT-pro BNP及TNF-α水平进行比较。AECOPD组根据患者是否合并SIRS分为伴SRIS组(78例)及不伴SIRS组(30例)两个亚组,比较两组NT-pro BNP及TNF-α水平,评估伴SIRS组患者NT-pro BNP与TNF-α的相关性。结果比较同期同年龄段健康对照组,AECOPD组及稳定期COPD组患者NT-pro BNP及TNF-α水平均明显升高,差异有统计学意义(P<0.05)。AECOPD组比较稳定期COPD组NT-pro BNP及TNF-α水平升高更为显著,差异有统计学意义(P<0.05)。而伴SIRS组患者NT-pro BNP及TNF-α水平更高于不伴SIRS组,差异有统计学意义(P<0.05),伴SIRS组NT-proBNP与TNF-α水平呈正相关,差异有统计学意义(P<0.05)。结论检测血清中NT-pro BNP与TNF-α水平有助于COPD急性加重及合并SIRS的识别。

Objective To investigate the significance of N-terminal pro-brain natriuretic peptide(NT-proBNP)and tumor necrosis factor-α(TNF-α)in diagnosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with systemic inflammatory response syndrome(SIRS).Methods Patients admitted to Beijing Chuiyangliu hospital from January 1,2018 to December 31,2019 were selected and divided into the AECOPD group(patients with AECOPD,n=108),the stable COPD group(outpatients of the same age at the same period with stable COPD,n=52)and the healthy control group(n=48)according to the medical records.The levels of NT-proBNP and TNF-αwere compared.The AECOPD group was divided into two subgroups,which were the group complicated with SRIS(n=78)and the group without SIRS(n=30)according to whether the patients were complicated with SIRS.The levels of NT-proBNP and TNF-αbetween the two groups were compared,and the correlation between NT-proBNP and TNF-αin patients with SIRS was evaluated.Results Compared with the healthy control group in the same period and same age,the levels of NT-proBNP and TNF-αof patients in the AECOPD group and the stable COPD group were significantly increased,with statistically significant differences(P<0.05).The levels of NT-proBNP and TNF-αin the AECOPD group were significantly higher than those in the stable COPD group,and the differences were statistically significant(P<0.05).The levels of NT-proBNP and TNF-αin patients of the group complicated with SIRS were higher than those of the group without SIRS,and the differences were statistically significant(P<0.05).Meanwhile,there was a positive correlation between NT-proBNP and TNF-αin the complicated with SIRS with statistically significant differences(P<0.05).Conclusion Detection of serum levels of NT-proBNP and TNF-αis helpful to identify acute exacerbation of COPD and complicated SIRS.