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目的探讨慢性阻塞性肺病(COPD)患者血浆白蛋白(PA)、C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)水平与肺动脉高压(PH)的关系。方法选取2011年9月到2013年9月期间收治的COPD患者88例,根据是否患有PH分为PH组52例和对照组36例。比较两组患者一般资料以及PA、CRP、TNF-α水平和肺动脉收缩压(PAP),并分析血浆PA、CRP、TNF-α水平和COPD患者PH发生率的关系。结果血浆PA水平与COPD患者PH发生率呈负相关(r=-0.58,P<0.01),血浆CRP水平与COPD患者PH发生率正相关(r=0.78,P<0.01),血浆TNF-α水平与COPD患者PH发生率呈正相关(r=0.62,P<0.01)。与对照组比较,PH组患者PaO2水平显著降低,PaCO2水平明显升高(P<0.05);血浆PA水平降低(P<0.01),血浆CRP和TNF-α水平以及PAP明显升高(P均<0.01)。结论血浆PA水平随着COPD患者PH发生率的升高而降低,而血浆CRP和TNF-α水平则随着COPD患者PH发生率的升高而升高。COPD患者血浆PA水平降低而CRP和TNF-α水平升高时应警惕PH的发生。
Objective To investigate the relationship between plasma albumin (PA), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and pulmonary hypertension (PH) in patients with chronic obstructive pulmonary disease (COPD) Methods Eighty-eight COPD patients were enrolled from September 2011 to September 2013. According to whether they had PH or not, 52 patients were divided into PH group and 36 patients in control group. The general data of patients, PA, CRP, TNF-α and pulmonary artery systolic pressure (PAP) were compared between the two groups. The levels of plasma PA, CRP, TNF-α and the incidence of PH in COPD patients were also analyzed. Results Plasma PA level was negatively correlated with the incidence of PH in COPD patients (r = -0.58, P <0.01). The plasma CRP level was positively correlated with the incidence of PH in COPD patients (r = 0.78, P <0.01) And the incidence of PH in COPD patients was positively correlated (r = 0.62, P <0.01). Compared with the control group, the PaO2 level and the PaCO2 level in the PH group were significantly decreased (P <0.05), the levels of PA in the plasma decreased (P <0.01), the levels of plasma CRP and TNF-α and the PAP were significantly increased (P < 0.01). Conclusion Plasma PA level decreases with the increase of PH in COPD patients, while plasma CRP and TNF-α levels increase with the increase of PH in COPD patients. COPD patients with plasma PA levels decreased while CRP and TNF-α levels should be vigilant PH occurred.