心肌肌钙蛋白T、脑钠肽及超敏C反应蛋白/白蛋白在慢性阻塞性肺病急性加重期并发呼吸衰竭诊断、预后评估中的应用研究

Application of cTnT,BNP and hs-CRP/Alb in the diagnosis and the prognosis evaluation of AECOPD complicated with respiratory failure

目的分析心肌肌钙蛋白T(cTnT)、脑钠肽(BNP)及超敏C反应蛋白(hs-CRP)/白蛋白(Alb)在慢性阻塞性肺病急性加重期(AECOPD)并发呼吸衰竭诊断、预后评估中的应用价值。方法选取2019年1月到2021年8月在我院治疗的AECOPD并发呼吸衰竭患者128例(观察组),另选取同期收治的未合并呼吸衰竭AECOPD者114例(对照组)。对比不同人群cTnT、BNP、hs-CRP/Alb表达情况及APACHEII评分,分析cTnT、BNP、hs-CRP/Alb与APACHEII相关性,以及cTnT、BNP、hs-CRP/Alb对AECOPD并发呼吸衰竭的诊断价值。结果观察组cTnT、BNP、hs-CRP/Alb表达水平及APACHEII评分均高于对照组(P<0.05);观察组预后良好101例,预后不良27例,预后不良组cTnT、BNP、hs-CRP/Alb表达水平及APACHEII评分均高于预后良好组(P<0.05);cTnT、BNP、hs-CRP/Alb与APACHEII评分均呈正相关(P<0.05);cTnT、BNP、hs-CRP/Alb诊断AECOPD并发呼吸衰竭的AUC分别为0.770、0.753、0.776。结论cTnT、BNP及hs-CRP/Alb与AECOPD并发呼吸衰竭者病情程度密切相关,可为临床诊断及预后评估提供参考。

Objective To analyze the application value of cardiac troponin T(cTnT),brain natriuretic peptide(BNP)and high sensitivity C-reactive protein(hs-CRP)/Albumin(Alb)in the diagnosis and the prognosis evaluation of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with respiratory failure.Methods A total of 128 AECOPD patients with respiratory failure treated in our hospital from January 2019 to August 2021 were selected as an observation group.At the same time,114 patients with AECOPD without respiratory failure admitted to our hospital were selected as a control group.The expressions of cTnT,BNP,and hs-CRP/Alb and APACHEII score were compared between the two groups.The correlation between the levels of cTnT,BNP and hs-CRP/Alb and the APACHEII was analyzed.The prognostic evaluation value of cTnT,BNP and hs-CRP/Alb in AECOPD complicated with respiratory failure was explored.Results The expression levels of cTnT,BNP and hs-CRP/Alb and APACHEII score in the observation group were significantly higher than those in the control group(P<0.05).In the observation group,there were 101 patients with good prognosis and 27 with poor prognosis.The expression levels of cTnT,BNP and hs-CRP/Alb and APACHEII score in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05).cTnT,BNP,and hs-CRP/Alb were positively correlated with APACHEII score(P<0.05).The AUC of cTnT,BNP and hs-CRP/Alb in the diagnosis of AECOPD with respiratory failure was 0.770,0.753 and 0.776,respectively.Conclusion cTnT,BNP and hs-CRP/Alb are closely related to the severity of AECOPD complicated with respiratory failure,and can provide references for clinical diagnosis and prognostic evaluation.