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目的研究稳定期慢性阻塞性肺病(SCOPD)合并稳定性心绞痛(SAP)患者血清心肺有关标志物特征与关联。方法选择SCOPD合并SAP患者242例(合并组)、SCOPD患者60例(SCOPD组)、健康体检者30名(健康组)。采集受试者一般资料,采空腹静脉血检测N端脑钠肽前体(NT-proBNP)、c Tn I、Clara细胞分泌蛋白(CC16)、表面活性蛋白-D(SP-D)、白介素-1β(IL-1β)、白介素-10(IL-10)及C反应蛋白(CRP),并行肺功能检测,比较上述指标的差异,并在SCOPD组及合并组患者中进行亚组分析,对合并组上述标志物进行线性相关分析。结果与健康组比较,两个患者组NT-pro-BNP、c Tn I、SP-D、IL-1β及CRP升高(P<0.05),SCOPD组低于合并组(P<0.05);而CC16和IL-10降低(P<0.05),合并组低于SCOPD组(P<0.05)。亚组分析显示大部分指标亦随病情加重而波动。合并组血清NT-pro-BNP、c Tn I与CC16呈负相关(P<0.01),与SP-D呈正相关(P<0.01);心肺有关标志物与部分炎症标志物相关(P<0.01)。结论 SCOPD合并SAP患者较SCOPD患者心肺损伤严重,炎症可能是其重要机制,且心肺有关标志物之间具有相关性。
Objective To study the characteristics and correlation of serum cardiopulmonary markers in patients with stable chronic obstructive pulmonary disease (SCOPD) and stable angina pectoris (SAP). Methods 242 patients with SCOPD complicated with SAP (combined group), 60 SCOPD patients (SCOPD group) and 30 healthy controls (healthy group) were selected. The general data of the subjects were collected and the fasting blood samples were collected for detection of NT-proBNP, cTnI, Clara cell secretory protein (CC16), surfactant protein-D (SP-D), interleukin- 1β, IL-10 and C-reactive protein (CRP) were measured. The pulmonary function tests were performed to compare the differences of the above indexes. The subgroups were analyzed in patients with SCOPD and those in the combined group. Group of the above markers for linear correlation analysis. Results The levels of NT-pro-BNP, cTn I, SP-D, IL-1β and CRP in the two groups were significantly higher than those in the healthy group (P <0.05) CC16 and IL-10 decreased (P <0.05), while those in the combined group were lower than those in the SCOPD group (P <0.05). Subgroup analysis showed that most of the indicators also fluctuated with the severity of the illness. The serum levels of NT-pro-BNP, cTn I and CC16 were negatively correlated (P <0.01), and positively correlated with SP-D (P <0.01). Cardiopulmonary related markers were correlated with some inflammatory markers (P <0.01) . Conclusion SCOPD patients with SAP have more severe cardiopulmonary injuries than those with SCOPD. Inflammation may be an important mechanism in patients with SCOPD complicated with SAP, and there is a correlation between cardiopulmonary related markers.