吸烟与炎性因子在慢性阻塞性肺疾病急性加重期合并肺动脉高压中的相关性

李亚萍; 李永霞; 牛小群; 海冰; 曹宇; 柴燕玲

吸烟与炎性因子在慢性阻塞性肺疾病急性加重期合并肺动脉高压中的相关性

昆明医科大学第二附属医院呼吸内科二病区

基金项目:

基金：云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目 (2015FB052);

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出版历程
- 收稿日期: 2017-04-21

Correlation between Smoking and Inflammatory Factors in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Pulmonary Hypertension

Funds:

基金：云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目 (2015FB052);

摘要

摘要: 目的探究吸烟、炎性因子在慢性阻塞性肺疾病急性加重期 (AECOPD) 患者合并肺动脉高压 (PH) 之间的关系.方法采用回顾性分析, 收集我院2015年3月至2016年3月呼吸内科二病区住院符合诊断标准的AECOPD合并肺动脉高压患者38例为实验组, 同期住院单纯AECOPD患者46例为对照组, 收集患者基本资料, 采集患者入院后24 h内的血清中白介素-6 (IL-6) 、降钙素原 (PCT) 、超敏C反应蛋白 (hs-CRP) 、N端脑钠肽前体 (NT-proBNP) , 胸部CT和超声心动图的结果, 比较对照组和实验组两组中上述指标.结果 AECOPD合并PH组的吸烟指数、hs-CRP、PCT、NT-proBNP均高于单纯AECOPD组 (P<0.05) , 且与肺动脉收缩压呈正相关 (P<0.05) , Logistic回归分析示NT-proBNP是肺动脉高压形成的独立危险因素 (OR=1.89, P<0.01) .结论吸烟和血清中的hs-CRP、PCT、NT-proBNP升高与肺动脉压力升高呈正相关, NT-proBNP是肺动脉压升高的危险因素, 吸烟和系统炎症反应参与了COPD肺动脉高压的形成.
- 慢性阻塞性肺疾病急性加重期 /
- 肺动脉高压 /
- 吸烟 /
- 炎性因子
Abstract: Objective To explore the relationship between acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and pulmonary hypertension (PH) in patients with chronic obstructive pulmonary disease (COPD) . Me thods Using retrospective analysis, we collected from March 2015 to March 2016 in the department of respiratory internal medicine (ward two) in our hospital, 38 cases of AECOPD combined with pulmonary hypertension patients as a experimental group, 46 cases of simple AECOPD patients in the same period as the controlgroup. And we collected basic data. The serum of Interleukin-6 (IL-6) , Procalcitonin (PCT) , High sensitive C reactive protein (hs-CRP) , N-Terminal pro-Brain natriuretic peptide (NT-proBNP) were collected after admission within 24 hours, the results of Chest CT and Ultrasonic echocardiography. Compared with the control group and experimental group of two groups in the above indicators. Re s ults AECOPD combined with PH group of the smoking index, hs-CRP, PCT, NT-proBNP were higher than the simple AECOPD group (P <0.05) , and had positive correlation with pulmonary artery systolic pressure (P<0.05) . Logistic regression analysis showed that NT-proBNP was an independent risk factor for pulmonary arterial hypertension (OR=1.89, P<0.01) .Clolus ions Smoking and serum hs-CRP, PCT, NT-proB NP are positively correlated with elevated pulmonary artery pressure, NT-proB NP is an independent risk factor for pulmonary arterial hypertension. Smoking and systemic inflammation are involved in the formation of pulmonary hypertension in COPD.
- Acute exacerbation of chronic obstructive pulmonary disease /
- Pulmonary arterial hypertension /
- Smoking /
- Pulmonary arterial hypertension

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参考文献(23)

[1]慢性阻塞性肺疾病诊治指南 (2013年修订版) [J].中国医学前沿杂志 (电子版) , 2014, 6 (2) :67-80.
[2]	[2]SHUJAAT A, BAJWA A A, CURY J D.Pulmonary Hypertension Secondary to COPD[J].Pulmonary Medicine, 2012, 2012:203952.
[3]	[3]GALIE N, HOEPER M M, HUMBERT M, et al.Guidelines for the diagnosis and treatment of pulmonary hypertension[J].Eur Heart J, 2009, 30:2493-2573.
[4]	[4]HILLAS G, PERLIKOS F, TSILIGIANNI I, TZANAKIS N.Managing comorbidities in COPD[J].International Journal of Chronic Obstructive Pulmonary Disease, 2015, 10:95-109.
[5]	[5]MARUNA P, NEDELNIKOVA K, GURLICH R.Physiology and genetics of procalcitonin[J].Physiological Research, 2000, 49:S57-S62.
[6]李珍, 徐鸥.降钙素原在慢性阻塞性肺疾病急性加重期的应用及进展[J].临床肺科杂志, 2015, 20 (4) :728-732.
[7]洪燕, 胡志雄, 周海英.降钙素原在慢性阻塞性肺病并肺动脉高压中的临床意义[J].中国医学工程, 2011, 19 (5) :26-28.
[8]林沛茹, 赵子文, 何桦, 李晓岩.Hs-CRP、降钙素原和动脉血气分析在慢性阻塞性肺疾病急性加重期合并肺动脉高压中的临床意义[J].实用医学杂志, 2016, 32 (2) :196-199.
[9]张晓慧, 李光韬, 张卓莉.C反应蛋白与超敏C反应蛋白的检测及其临床意义[J].中华临床免疫和变态反应杂志, 2011, 1 (1) :74-79.
[10]曹敬银, 陆元培.C反应蛋白在呼吸系统疾病中的研究进展[J].临床肺科杂志, 2010, 15 (9) :1290-1291.
[11]	[11]BLACK S, KUSHNER I, SAMOLS D, et al.C-reactive Protein[J].J Biol Chem, 2004, 279 (41) :48487-48490.
[12]	[12]KWONY S, CHI S Y, SHIN H J, et al.Plasma C-reactive protein and endothelin-1 level in patients with chronic obstructive pulmonary disease and pulmonary hypertension.[J].Journal of Korean Medical Science, 2010, 25 (10) :1487-91.
[13]	[13]KISHIMOTO T.Interleukin-6:discovery of a pleiotropic cytokine.Arthritis Res Ther 2006, 8 (Suppl 2) :S2.
[14]王海龙, 孙丽蓉.IL-6基因多态性与COPD肺动脉高压研究进展[J].临床肺科杂志, 2011, 16 (12) :1928-1930.
[15]	[15]SAVALE L, TU L, RIDEAU D, et al.Impact of interleukin-6 on hypoxia-induced pulmonary hypertension and lung inflammation in mice[J].Respiratory Research, 2009, 10 (2) :1-13.
[16]	[16]CHAOUAT A, SAVALE L, CHOUAID CH, et al.Role for Interleukin-6 in COPD-Related Pulmonary Hypertension[J].Chest, 2009, 136 (3) :678-687.
[17]	[17]JOPPA P, PETRASOVA D, STANCAK B, et al.Systemic inflammation in patients with COPD and pulmonary hypertension[J].Chest, 2006, 130 (2) :326-333.
[18]陈刘通, 廖晨, 涂洪波, 等.吸烟及全身炎症反应与慢性阻塞性肺疾病患者中发生肺动脉高压的相关性研究[J].第三军医大学学报, 2016, (11) :1293-1296.
[19]	[19]WANG F, PAN W, PAN S, et al.Usefulness of N-terminal pro-brain natriuretic peptide and C-reactive protein to predict ICU mortality in unselected medical ICU patients:a prospective, observational study[J].Critical Care, 2011, 15 (1) :1-9.
[20]	[20]CHI S Y, KIM E Y, BAN H J, et al.Plasma N-terminal Pro-brain Natriuretic Peptide:A Prognostic Marker in Patients with Chronic Obstructive Pulmonary Disease[J].Lung, 2012, 190 (3) :271-276.
[21]顾翔, 陈玉玲, 左丽娜, 等.hs-CRP、Fib、NT-pro BNP在COPD合并肺动脉高压中的研究及意义[J].临床肺科杂志, 2014, 19 (11) :1969-1972.
[22]	[22]BARBER J A.Mechanisms of development of chronic obstructive pulmonary disease-associated pulmonary hypertension[J].Pulm Circ, 2013, 3 (1) :160-4.
[23]	[23]ZHOU S, LI M, ZENG D, et al.Effects of basic fibroblast growth factor and cyclin D1 on cigarette smoke-induced pulmonary vascular remodeling in rats.[J].Experimental&Therapeutic Medicine, 2015, 9 (1) :33-38.

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