慢性阻塞性肺疾病急性加重期患者血清BNP、ET-1和PCT水平与病情严重程度及预后关系

Relationship between serum BNP,ET-1 and PCT levels and disease severity and prognosis in acute exacerbation of chronic obstructive pulmonary disease

目的分析慢性阻塞性肺疾病急性加重期(AECOPD)患者血清BNP、ET-1和PCT水平与病情严重程度及预后的关系。方法实验组选取2018年6月至2020年6月来青海省心脑血管病专科医院进行治疗COPD患者264例,对照组选取同期来该院体检的正常人群100例,实验组患者病情严重程度可根据SAPSII评分值将患者分为轻度组106例(20~30分)、中度组95例(30~40分)和重度组63例(>40分);以死亡或随访6个月为终点事件,随访患者预后情况,根据患者预后分为死亡组(n=75)和好转组(n=189);抽取两组空腹肘静脉血5mL,测定血清脑钠肽(BNP)、降钙素原(PCT)和内皮素-1(ET-1)水平;采用Pearson相关性分析血清BNP、ET-1和PCT水平与AECOPD病情严重程度及预后的相关性。结果对血清BNP、ET-1和PCT水平的分析发现,实验组显著高于对照组(P<0.05);重度组显著高于轻度组和中度组(P<0.05),而中度组也显著高于轻度组(P<0.05);死亡组显著高于好转组(P<0.05);经Pearson相关性分析,AECOPD患者病情严重程度与血清BNP、ET-1和PCT水平呈正相关,相关系数为(r=0.447、0.472、0.593,P<0.05);AECOPD患者预后与血清BNP、ET-1和PCT水平呈正相关,相关系数为(r=0.507、0.503、0.612,P<0.05)。结论血清BNP、ET-1和PCT水平可用于判断AECOPD病情严重程度及患者预后。

Objective To analyze the relationship between serum BNP,ET-1 and PCT levels and disease severity and prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods The experimental group selected 264 COPD patients who came to Qinghai Special Hospital for cardiovascular and Cerebrovascular Diseases from June 2018 to June 2020,and the control group selected 100 normal people who came to our hospital for physical examination during the same period.According to SAPSII score,patients in the experimental group were divided into mild group(106 cases),moderate group(95 cases)and severe group(63 cases)according to SAPSII score.The end point was death or 6-month follow-up,and the patients were followed up and divided into the death group(n=75)and the improvement group(n=189)according to the prognosis.Five ml of fasting elbow venous blood was taken from the two groups,and the levels of brain natriuretic peptide(BNP),procalcitonin(PCT)and endothelin-1(ET-1)in serum were determined.Pearson correlation was used to analyze the correlation between serum BNP,ET-1 and PCT levels and the severity and prognosis of AECOPD.Results The serum BNP,ET-1 and PCT levels in the experimental group were significantly higher than those in the control group(P<0.05).The severe group was significantly higher than the mild and moderate groups(P<0.05),and the moderate group was significantly higher than the mild group(P<0.05);The mortality group was significantly higher than the improvement group(P<0.05).Pearson correlation analysis showed that there was a positive correlation between the severity of AECOPD patients and the levels of BNP,ET-1 and PCT(r=0.447,0.472,0.593,P<0.05).The prognosis of AECOPD patients was positively correlated with the serum BNP,ET-1 and PCT levels(r=0.507,0.503,0.612,P<0.05).Conclusion Serum BNP,ET-1 and PCT levels can be used to judge the severity and prognosis of AECOPD.