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目的:探讨慢性阻塞性肺疾病（COPD）患者继发肺动脉高压（PH）的预测因素。方法:选取徐州医科大学附属淮安医院2017年9月至2019年12月住院并确诊的COPD患者171例，利用超声心动图估测肺动脉收缩压，并将患者分为单纯COPD组（71例）和COPD合并PH组（100例）。分别收集各组患者的一般临床资料、血液学指标、肺功能指标，对各组数据进行统计分析，探讨上述因素对COPD发生PH的预测价值。结果:COPD合并PH组平均血小板体积（MPV）、红细胞分布宽度（RDW）、氨基末端脑钠肽前体（NT-proBNP）的对数值（lgNT-proBNP）高于单纯COPD组[（11.91 ± 2.60） fl比（10.39 ± 1.44） fl、（14.25 ± 2.49）%比（12.56 ± 1.12）%、（2.82 ± 0.54） ng/L比（2.22 ± 0.38）ng/L]，第1秒用力呼气容积（FEVn 1）与用力肺活量（FVC）的比值（FEVn 1/FVC）、FEVn 1占预计值百分比（FEVn 1%）低于单纯COPD组[（51.43 ± 8.07）%比（59.99 ± 8.33）%、（37.00 ± 12.62）%比（48.28 ± 15.10）%]，差异均有统计学意义（n P<0.05）。Logistic回归分析显示，MPV（n OR = 1.401，n P = 0.015）、RDW（n OR = 1.769，n P = 0.013）、lgNT-proBNP（n OR = 6.959，n P<0.001）、FEVn 1/FVC（n OR = 0.905，n P<0.001）是COPD发生PH的预测因素。MPV、RDW、NT-proBNP诊断PH的受试者工作特征曲线分析结果显示，三者联合诊断PH的曲线下面积最大为0.873。n 结论:NT-ProBNP、RDW、MPV、FEVn 1/FVC的变化对COPD合并PH具有一定的预测价值，三项血液学指标联合检测较单一检测及两两联合检测能更好地预测COPD患者PH的存在。n “,”Objective:To explore the predictive factors of secondary pulmonary hypertension (PH) in patients with chronic obstructive pulmonary disease (COPD).Methods:The patients who were hospitalized and diagnosed with COPD in Huai′an Hospital Affiliated to Xuzhou Medical University from September 2017 to December 2019 were enrolled, and the pulmonary systolic pressure were estimated by echocardiography. The patients were divided into simple COPD group and COPD combined with PH group. The general clinical data, hematology indexes, and pulmonary function indexes of each group were collected and analyzed to explore the predictive value of the above factors on the occurrence of PH in COPD.Results:The levels of average blood platelet volume (MPV), red blood cell distribution width (RDW), and logarithmic functionof amino-terminal brain natriuretic precursor (lgNT-proBNP) in the in the COPD combined with PH group were higher than those in the simple COPD group: (11.91 ± 2.60) fl vs. (10.39 ± 1.44) fl, (14.25 ± 2.49)% vs. (12.56 ± 1.12)%, (2.82 ± 0.54) ng/L vs. (2.22 ± 0.38) ng/L; the ratio of forced expiratory volume in the first second (FEVn 1) and force vital capacity (FVC) and the percentage of FEVn 1 to the predicted value (FEVn 1%) were lower than those in the simple COPD group: (51.43 ± 8.07)% vs. (59.99 ± 8.33)%, (37.00 ± 12.62)% vs. (48.28 ± 15.10)%, the differences were statistically significant (n P<0.05). Logistic regression analysis showed that the changes of MPV(n OR = 1.401, n P = 0.015), RDW (n OR = 1.769, n P = 0.013), lgNT-proBNP (n OR = 6.959, n P<0.001), FEVn 1/FVC(n OR = 0.905, n P<0.001) were closely related to the occurrence of PH in COPD. The receiver operating characteristic (ROC) curve analysis showed that the area under the curve of MPV, RDW, NT-proBNP combined detection in diagnosis of PH was the largest (0.873).n Conclusions:The changes in NT-proBNP, RDW, MPV, FEVn 1/FVC have a certain predictive value for COPD patients with PH. The combined detection of three hematological indicators can better predict the presence of PH in COPD patients than single detection or combined detection.n