联合检测RDW、D-二聚体和BNP在慢性阻塞性肺病病情评估及预后中的价值

The value of combined detection of RDW,D-dimer and BNP in the evaluation and prognosis of chronic obstructive pulmonary disease

目的探讨联合检测红细胞分布宽度(RDW)、D-二聚体(D-D)、脑钠肽(NT-pro BNP)在慢性阻塞性肺病(COPD)早期诊断、病情评估及预后预测中的价值。方法分析2019年7月至2021年4月内蒙古包头市包钢集团第三职工医院呼吸科及ICU收治的162例COPD患者为COPD组,及同期100例健康体检人员实验室检查及临床资料为对照组。比较COPD组与对照组RDW、D-D、BNP水平差异。同时将COPD患者从病情严重程度、是否存在合并症、及预后等维度进行分组,比较不同维度下患者RDW、D-D、BNP水平组间差异。同时用Person分析RDW、D-D、BNP水平与病情严重程度相关性。结果 COPD组患者BNP、D-D、RDW水平高于对照组,差异有统计学意义(P<0.05);不同病情程度组BNP、D-D、RDW水平比较,重度组>中度组>轻度组,差异有统计学意义(P<0.05);合并肺动脉高压及呼吸衰竭患者BNP、D-D、RDW水平显著高于未合并肺动脉高压及呼吸衰竭患者;死亡组患者BNP、D-D、RDW水平显著高于未死亡组,差异均有统计学意义(P<0.05);BNP、D-D、RDW分别与病情严重程度存在正相关(r_(1)=0.853,r_(2)=0.853,r_(3)=0.856,P<0.05)。结论联合检测RDW、D-D、BNP对COPD早期诊断、病情评估及预后预测具有较高价值。

Objective To explore the value of combined detection of red blood cell distribution width(RDW),D-Dimer(D-D)and brain natriuretic peptide(NT Pro BNP)in the early diagnosis,condition evaluation and prognosis of chronic obstructive pulmonary disease(COPD). Methods the laboratory examination and clinical data of 162 patients with COPD treated at the respiratory department and ICU of The Third Staff Hospital of Baotou Steel Group,Inner Mongolia from July 2019 to April 2021 and 100 healthy physical examination personnel in the same period were analyzed retrospectively. The serum RDW,D-D and BNP levels of COPD patients and normal physical examination personnel were compared. At the same time,COPD patients were divided into groups according to the severity of the disease,whether there were complications,and prognosis. The differences of serum RDW,D-D and BNP levels in different dimensions were compared. The correlation between the levels of RDW,D-D and BNP and the severity of the disease was analyzed by Pearson analysis. Results The levels of BNP,D-D and RDW in the COPD group were significantly higher than those in the normal physical examination group(P<0.05). Comparison of the levels ofBNP,D-D and RDW in different disease severity groups,severe group >moderate group >light group,the difference was statistically significant(P<0.05). The levels of BNP,D-D and RDW in patients with pulmonary hypertension and respiratory failure were significantly higher than those without pulmonary hypertension and respiratory failure. The levels of BNP,D-D and RDW in the dead group were significantly higher than those in the non-dead group,and the differences were statistically significant(P<0.05). BNP,D-D,and RDW were positively correlated with the severity of the disease(r_(1)=0.853,r_(2)=0.853,r_(3)=0.856 P<0.05). Conclusion The combined detection of RDW,D-D and BNP has high predictive value for the early diagnosis,condition evaluation and prognosis of COPD.