间质性肺疾病急性加重期患者外周血D-二聚体、B型钠尿肽的检测应用

Analysis of the Detection Value of Peripheral Blood D-dimer and B-type Natriuretic Peptide in Patients with Acute Exacerbation of Interstitial Lung Disease

目的 探讨分析外周血D-二聚体(D-dimer, D-D)、B型钠尿肽(B-type natriuretic peptide, BNP)在间质性肺疾病(interstitial lung disease, ILD)急性加重期患者中的检测价值。方法 选取2021年6月至2023年5月安阳市人民医院收治的96例ILD急性加重期患者纳入A组,同时将45例体检健康人纳入B组作为对照,比较两组D-D、BNP水平差异;同时所有ILD急性加重期患者出院后均随访3个月,根据患者是否死亡分为死亡组与存活组,比较两组患者一般资料、临床特征及D-D、BNP水平差异,采用ROC曲线分析D-D、BNP对于ILD急性加重期患者预后的预测效能。结果 A组D-D、BNP水平均明显高于B组(P<0.05);随访3个月后,死亡患者共54例,占比56.25%,存活患者共42例,占比43.75%;死亡组D-D、BNP水平均明显高于存活组(P<0.05);死亡组与存活组患者性别、BMI等一般资料差异无统计学意义(P>0.05),死亡组年龄、合并糖尿病占比、呼吸困难占比、咯血占比、晕厥占比、胸痛占比均高于存活组(P<0.05);ROC曲线分析显示,D-D、BNP及两项联合预测ILD急性加重期患者预后的敏感性分别为53.70%、70.37%、83.33%;特异性分别为90.48%、78.57%、80.95%;AUC分别为0.727、0.805、0.866(P<0.05)。结论 ILD急性加重期患者D-D、BNP水平出现明显改变,D-D、BNP对于ILD急性加重期患者预后具有较高预测效能。

Objective To explore and analyze the detection value of peripheral blood D-dimer(D-D)and B-type natriuretic peptide(BNP)in patients with acute exacerbation of interstitial lung disease(ILD).Methods A total of 96 ILD patients admitted to Anyang People′s Hospital from June 2021 to May 2023 were included in group A,while 45 healthy subjects were included in group B as control,and the differences in D-D and BNP levels between the two groups were compared;at the same time,all patients with acute ILD were followed up for 3 months after discharge,and were divided into death group and survival group according to whether the patients died or not.The general data,clinical characteristics and differences in D-D and BNP levels between the two groups were compared,and the predictive efficacy of D-D and BNP in the prognosis of patients with acute ILD were analyzed by ROC curve.Results The levels of D-D and BNP in group A were significantly higher than those in group B(P<0.05).After 3 months of follow-up,54 patients died,accounting for 56.25%,and 42 patients survived,accounting for 43.75%.The levels of D-D and BNP in death group were significantly higher than those in survival group(P<0.05).There were no significant differences in gender,BMI and other general data between the death group and the survival group(P>0.05).The death group was higher than the survival group in age,diabetes mellitus,dyspnea,hemoptysis,syncope and chest pain(P<0.05).ROC curve analysis showed that the sensitivity of D-D,BNP and the combination in predicting the prognosis of acute ILD patients was 53.70%,70.37%and 83.33%,respectively.The specificity was 90.48%,78.57%,80.95%,respectively.AUC was 0.727,0.805 and 0.866,respectively(P<0.05).Conclusion The levels of D-D and BNP were significantly changed in patients with acute ILD exacerbation,and D-D and BNP had high prognostic efficacy in patients with acute ILD exacerbation.