CAJ | 학술논문

目的：探讨慢性阻塞性肺病（COPD）合并充血性心力衰竭的实验室诊断价值，通过联合检测血清B型钠尿肽（BNP）、超敏C反应蛋白（hs‐CRP）及血浆血红蛋白浓度（Hb）来反应在该病中的临床应用价值。方法检测205例明确诊断为COPD的不同病因、不同分级（根据肺功能检查标准气流受限的程度对COPD严重度分为Ⅰ～Ⅳ级）患者以及100名健康体检者（对照组）的血清BNP、hs‐CRP及血浆Hb水平。评价各指标的敏感度和特异度，并分析3项指标联合检测的诊断价值。结果血清BNP、hs‐CRP及血浆 Hb水平在COPD不同分级之间差异有统计学意义（P＜0．05），且气流受限程度越大，其水平越高；COPDⅠ级患者与对照组比较，BNP、Hb水平差异有统计学意义（P＜0．05），hs‐CRP水平差异无统计学意义（P＞0．05）。COPD患者3项指标联合检测对早期COPD的敏感度为90．2％，明显高于单项检测（P＜0．05）。结论 COPD早期诊断可以通过联合检测血清BNP、hs‐CRP及血浆Hb来作为参考。
목적：탐토만성조새성폐병（COPD）합병충혈성심력쇠갈적실험실진단개치，통과연합검측혈청B형납뇨태（BNP）、초민C반응단백（hs‐CRP）급혈장혈홍단백농도（Hb）래반응재해병중적림상응용개치。방법검측205례명학진단위COPD적불동병인、불동분급（근거폐공능검사표준기류수한적정도대COPD엄중도분위Ⅰ～Ⅳ급）환자이급100명건강체검자（대조조）적혈청BNP、hs‐CRP급혈장Hb수평。평개각지표적민감도화특이도，병분석3항지표연합검측적진단개치。결과혈청BNP、hs‐CRP급혈장 Hb수평재COPD불동분급지간차이유통계학의의（P＜0．05），차기류수한정도월대，기수평월고；COPDⅠ급환자여대조조비교，BNP、Hb수평차이유통계학의의（P＜0．05），hs‐CRP수평차이무통계학의의（P＞0．05）。COPD환자3항지표연합검측대조기COPD적민감도위90．2％，명현고우단항검측（P＜0．05）。결론 COPD조기진단가이통과연합검측혈청BNP、hs‐CRP급혈장Hb래작위삼고。
Objective To investigate the Laboratory diagnostic value of COPD with congestive cardiac failure .The clinical signif‐icance on the combined detection of the serum B‐type natriuretic peptide(BNP) ,high sensitive C reactive protein (hs‐CRP) ,and he‐moglobin(Hb) in COPD with congestive cardiac failure .Methods The serum levels of BNP ,hs‐CRP and Hb in 205 patients with different etiological factors and grades(according to the pulmonary function test Ⅰ - Ⅳ) and 100 healthy controls were determined . The sensitivity and specificity of 3 parameters were evaluated .Results The levels of BNP ,hs‐CRP ,and Hb in different grades of COPD had statistical significance(P<0 .05) .In addition ,the grade was worse ,and its concentration was higher .The levels of BNP and Hb showed statistical significance between COPD I grade patients and healthy controls (P<0 .05) ,and the levels of hs‐CRP had no statistical significance between the healthy controls and COPD Ⅰgrade patients(P>0 .05) .The sensitivity of combined detection was 90 .2% in early COPD diagnosis ,which was higher significantly than that of the individual detection (P<0 .05) .Conclusion The significant clinical significance on the combined detection of the serum BNP ,hs‐CRP and Hb provides reference support in the diagnosis of early COPD .