本文選題：B型鈉尿肽 + 超敏C反應(yīng)蛋白�。� 參考：《皖南醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)是一種呼吸系統(tǒng)常見(jiàn)疾病。本文通過(guò)觀察COPD急性加重期及穩(wěn)定期患者血清中BNP與hs-CRP的水平,以及BNP與hs-CRP數(shù)值之間變化的關(guān)系,探討B(tài)NP與hs-CRP在臨床判斷COPD病情嚴(yán)重程度和指導(dǎo)治療中的意義。方法:選擇我院急診科2015年03月-2016年10月因COPD急性加重住院的患者70例為A組,住院或門診復(fù)診的24例COPD穩(wěn)定期患者為B組,我院體檢30例健康者為對(duì)照組C組,測(cè)定三組患者血清BNP及hs-CRP水平,比較各組血清BNP與hs-CRP水平差異;其次分析A組患者的BNP、hs-CRP與慢性阻塞性肺疾病的全球性倡儀(Global Initiative for chronic obstructive pulmonary disease,GOLD)分級(jí)的相關(guān)性,分析其在反應(yīng)病情嚴(yán)重程度中的作用;最后比較A組患者治療前后BNP、hs-CRP及EF值的變化。結(jié)果:(1)A組的AECOPD患者治療前的BNP水平為180.44±75.79pg/ml,hs-CRP水平為38.97±18.21mg/L,兩項(xiàng)數(shù)據(jù)均為三組間最高值(P0.01);B組的穩(wěn)定期COPD患者BNP、hs-CRP的檢測(cè)水平分別84.70±14.28pg/ml,17.63±6.23mg/L,而C組健康者血清BNP、hs-CRP濃度為三組間最低,BNP=39.17±10.15pg/ml、hs-CRP=1.30±0.47mg/L;這些差異均有統(tǒng)計(jì)學(xué)意義(P0.01)(2)Pearson相關(guān)性分析可知94例COPD患者血清BNP與hs-CRP呈線性相關(guān),且為正相關(guān)(r=0.825,P0.001),回歸方程為y(BNP)=39.647+3.471x(CRP)。(3)根據(jù)GOLD分級(jí),70例AECOPD患者BNP、hs-CRP水平與GOLD分級(jí)水平呈梯度增加,再通過(guò)Pearson相關(guān)分析可知BNP、hs-CRP水平與AECOPD患者的GOLD評(píng)分分級(jí)均呈正相關(guān)(r=0.581,P0.01和r=0.401,P0.01)。(4)A組經(jīng)正規(guī)治療后血清BNP、hs-CRP水平變化較治療前濃度比較均明顯下降,且這種差異有顯著統(tǒng)計(jì)學(xué)意義(P0.01),患者治療前后EF值分別為59.30±10.74%,62.40±10.35%,治療前后差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.084)。結(jié)論:1.AECOPD患者血漿BNP及hs-CRP水平高于穩(wěn)定期COPD患者及健康患者,急性期治療后兩指標(biāo)均下降,這些差異均有統(tǒng)計(jì)學(xué)意義(P0.01),可在臨床指導(dǎo)治療。2.聯(lián)合檢測(cè)BNP及hs-CRP在AECOPD患者臨床病情嚴(yán)重程度判斷及臨床治療中有一定的指導(dǎo)意義,在沒(méi)有肺功能儀的情況下可考慮作為一種判斷COPD患者病情嚴(yán)重程度及指導(dǎo)治療方式。
[Abstract]:Objective: chronic obstructive pulmonary disease (copd) is a common respiratory disease. By observing the levels of BNP and hs-CRP in the serum of patients with acute exacerbation and stable stage of COPD, and the relationship between BNP and hs-CRP, the significance of BNP and hs-CRP in judging the severity of COPD and guiding the treatment were discussed. Methods: from March 2015 to October 2016, 70 patients with acute exacerbation of COPD were selected as group A, 24 stable COPD patients in hospital or outpatient department as group B, and 30 healthy persons as control group. The levels of serum BNP and hs-CRP were measured, and the differences of serum BNP and hs-CRP were compared among the three groups. Secondly, the correlation between BNP hs-CRP and global Initiative for chronic obstructive pulmonary disease grade of chronic obstructive pulmonary disease (COPD) was analyzed. Finally, the changes of BNPHs-CRP and EF in group A were compared before and after treatment. Results before treatment, the BNP level of AECOPD patients in group A was 180.44 鹵75.79 PG / ml hs-CRP was 38.97 鹵18.21 mg / L, the two data were the highest among the three groups, the levels of BNPHs-CRP in stable COPD patients in group B were 84.70 鹵14.28 mg / ml 鹵6.23 mg / L, respectively, while the lowest levels of BNPhs-CRP in C group were 39.17 鹵10.15 mg / L of BNP-hs-CRP-1. 30 鹵0.47mgL / L of stable COPD patients, and the lowest levels of BNPHs-CRP in healthy subjects were 39.17 鹵10.15pg / ml / L and 1.30 鹵0.47mgL / L, respectively84.70 鹵14.28pgml / ml 鹵6.23 mg / L, respectively. There was a linear correlation between serum BNP and hs-CRP in 94 patients with COPD. The regression equation was y(BNP)=39.647 3.471xhs-CRP and GOLD grading. According to the GOLD grading, the levels of BNPHs-CRP and GOLD grade were increased in 70 patients with AECOPD. The Pearson correlation analysis showed that the level of BNPHs-CRP was positively correlated with the GOLD scores of AECOPD patients, and the changes of serum BNPHs-CRP levels in group A were significantly lower than those before treatment. The EF of the patients before and after treatment was 59.30 鹵10.74 and 62.40 鹵10.355.There was no significant difference before and after treatment. Conclusion 1. The levels of plasma BNP and hs-CRP in AECOPD patients were higher than those in stable COPD patients and healthy patients, and the two indexes were decreased after acute treatment. The differences were statistically significant (P 0.01) and could be used to guide the treatment. 2. The combined detection of BNP and hs-CRP has certain guiding significance in judging the severity of clinical condition and clinical treatment in AECOPD patients. In the absence of pulmonary function instrument, it can be considered as a way to judge the severity of the disease in patients with COPD and to guide the treatment.
【學(xué)位授予單位】：皖南醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R563.9

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 周希;李法琦;岳瑞華;;腦鈉素在心血管疾病中的作用及研究進(jìn)展[J];中國(guó)老年學(xué)雜志;2013年09期

2 梁瑞芳;李蘭菊;郭洪海;周健;岳紅衛(wèi);劉永杰;;血清BNP和IL-8聯(lián)合檢測(cè)在慢性阻塞性肺疾病急性加重期合并心力衰竭中的診斷價(jià)值[J];山西醫(yī)藥雜志(下半月刊);2012年07期

3 李朝梁;黃文艷;石秋玲;李博;楊慧;朱平先;;丹參酮ⅡA對(duì)充血性心力衰竭患者心功能和血管內(nèi)皮細(xì)胞分泌功能的影響[J];中西醫(yī)結(jié)合心腦血管病雜志;2012年02期

4 王科;閔婕;樊濤;鐘云清;;慢性阻塞性肺疾病患者院外用藥情況的調(diào)查研究[J];華西醫(yī)學(xué);2011年10期

5 喬人立;;重新認(rèn)識(shí)慢性阻塞性肺疾病與肺源性心臟病[J];中華結(jié)核和呼吸雜志;2011年04期

6 王聯(lián)發(fā);吳振西;陳紹良;紀(jì)勤炯;周文兵;黃振平;;腦利鈉肽與高血壓左室肥厚及舒張功能的關(guān)系[J];中華全科醫(yī)學(xué);2010年09期

7 王日軍;李慧芳;張?jiān)掳?雷新宇;張悟棠;張曉娟;陳潔;柴曉紅;董晉;王敬萍;;重組人腦利鈉肽治療老年慢性心衰患者急性加重期的臨床療效觀察[J];中國(guó)老年學(xué)雜志;2010年09期

8 李彥華;許強(qiáng);;體質(zhì)指數(shù)與老年心力衰竭患者血漿腦利鈉肽水平的相關(guān)性研究[J];臨床心血管病雜志;2010年04期

9 王曉華;;C反應(yīng)蛋白與穩(wěn)定期慢性阻塞性肺病及其肺功能關(guān)系的臨床研究[J];現(xiàn)代實(shí)用醫(yī)學(xué);2010年03期

10 梁劍;李斌愷;鄭云;;腦鈉素水平變化在慢性阻塞性肺疾病病情監(jiān)測(cè)和預(yù)后評(píng)價(jià)中的意義[J];廣東醫(yī)學(xué);2009年08期

，

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