PCT、D-dimer和NT-proBNP水平及肺功能与儿童喘息性疾病相关肺动脉高压关系

ASSOCIATION OF PROCALCITONIN,D-DIMER,N-TERMINAL PRO-BRAIN NATRIURETIC PEPTIDE,AND PULMONARY FUNCTION WITH WHEEZING-ASSOCIATED PULMONARY HYPERTENSION IN CHILDREN

目的探讨降钙素原(PCT)、D-二聚体(D-dimer)和氨基末端脑钠肽前体(NT-proBNP)水平及肺功能与儿童喘息性疾病相关肺动脉高压关系。方法选取喘息性疾病病儿80例作为研究对象,其中继发肺动脉高压(PH组)30例,非肺动脉高压(非PH组)50例。比较两组血清PCT、D-dimer、NT-proBNP水平及肺功能变化,直线相关分析肺动脉收缩压与血清标志物之间的相关性。结果PH组D-dimer、NT-proBNP水平高于非PH组,差异均有统计学意义(t=-4.92、-7.79,P<0.05)。相关性分析显示,D-dimer、NT-proBNP与肺动脉收缩压均呈正相关(r=0.448、0.416,P<0.05)。PH组潮气量(VT/kg)、呼吸比(TI/TE)、达峰时间比(TPEF/TE)、达峰容积比(VPEF/VE)均低于非PH组,差异有统计学意义(t=3.49~5.95,P<0.05)。结论D-dimer、NT-proBNP水平与肺动脉高压的发病风险存在相关性。儿童喘息疾病均存在不同程度小气道阻塞,肺动脉高压病人的肺功能状态下降显著,肺功能检测可以客观评价气道阻塞程度,有助于早期筛查可疑肺动脉高压。

Objective To investigate the association of procalcitonin(PCT),D-dimer,N-terminal pro-brain natriuretic peptide(NT-proBNP),and pulmonary function with wheezing-associated pulmonary hypertension(PH)in children.Methods A total of 80 children with wheezing diseases were enrolled as subjects,among whom 30 had PH(PH group)and 50 did not have PH(non-PH group).The two groups were compared in terms of the serum levels of PCT,D-dimer,and NT-proBNP and the change in pulmonary function,and a linear regression analysis was performed to investigate the correlation between pulmonary artery systolic pressure and serum markers.Results The PH group had significantly higher levels of D-dimer and NT-proBNP than the non-PH group(t=-4.92,-7.79;P<0.05).The correlation analysis showed that D-dimer and NT-proBNP were positively correlated with pulmonary artery systolic pressure(r=0.448,0.416;P<0.05).Compared with the non-PH group,the PH group had significantly lower tidal volume,inspiratory-to-expiratory time ratio,ratio of time to peak tidal expiratory flow to total expiratory time,and ratio of volume to peak tidal expiratory flow to total expiratory volume(t=3.49-5.95,P<0.05).Conclusion D-dimer and NT-proBNP levels are associated with the risk of PH.There are varying degrees of small airway obstruction in wheezing diseases in children,and children with PH have a significant reduction in pulmonary function.Pulmonary function examination can objectively evaluate the degree of airway obstruction and help with early screening of suspected PH.