高级检索

血清25羟维生素D、心型脂肪酸结合蛋白及N末端脑利钠肽前体评估慢性阻塞性肺疾病急性加重期患者早期心肌损伤的价值

Value of serum 25-hydroxyvitamin D, heart-type fatty acid-binding protein and N-terminal pro-brain natriuretic peptide in assessing early myocardial injury in patients with acute exacerbation of chronic obstructive pulmonary disease

    摘要
  • 摘要:
    目的 探究血清25羟维生素D25-(OH)D、心型脂肪酸结合蛋白(H-FABP)、N末端脑利钠肽前体(NT-ProBNP)对慢性阻塞性肺疾病急性加重期(AECOPD)患者早期心肌损伤的评估价值。
    方法 选取AECOPD患者120例(AECOPD组)纳入本研究, 依据是否发生早期心肌损伤分为损伤组(n=68)和未损伤组(n=52), 并纳入同期体检的健康人员40例为对照组，比较血清25-(OH)D、H-FABP、NT-ProBNP水平差异，并分析三者与临床资料的相关性。采用二元Logistic回归分析探讨三者与早期心肌损伤发生的关系; 采用受试者工作特征(ROC)曲线分析三者对AECOPD患者早期心肌损伤的诊断价值。
    结果 AECOPD组第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、第1秒用力呼气容积与用力肺活量比值(FEV1/FVC)、动脉血氧分压pa(O2)水平低于对照组，动脉血二氧化碳分压pa(CO2)水平高于对照组，差异有统计学意义(P < 0.05); AECOPD组和损伤组血清25-(OH)D水平分别低于对照组和未损伤组, H-FABP、NT-ProBNP水平高于对照组和未损伤组，差异有统计学意义(P < 0.05); AECOPD患者血清25-(OH)D与FEV1、FVC、FEV1/FVC、pa(O2)呈正相关，与pa(CO2)呈负相关(P < 0.05); H-FABP、NT-ProBNP与FEV1、FVC、FEV1/FVC、pa(O2)呈负相关，与pa(CO2)呈正相关(P < 0.05)。二元Logistic回归分析显示, 25-(OH)D、H-FABP和NT-ProBNP是AECOPD患者早期心肌损伤的相关影响因素(P < 0.05); ROC曲线分析结果显示, 25-(OH)D、H-FABP和NT-ProBNP评估心肌损伤状态的曲线下面积(AUC)分别为0.814、0.959、0.837, 联合评估的AUC为0.983, 敏感度为97.06%, 特异度为80.77%。
    结论 早期心肌损伤AECOPD患者会出现血清25-(OH)D低表达、H-FABP和NT-ProBNP高表达情况，三者与早期心肌损伤有一定相关性，可作为临床诊断的参考指标。

     

    Abstract:
    Objective To investigate the evaluation value of serum 25-hydroxyvitamin D25-(OH)D, heart-type fatty acid-binding protein (H-FABP), and N-terminal pro-brain natriuretic peptide (NT-ProBNP) in early myocardial injury in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
    Methods A total of 120 patients with AECOPD (AECOPD group) were enrolled in this study. Based on the presence of early myocardial injury, they were divided into injury group (n=68) and non-injury group (n=52). Additionally, 40 healthy individuals undergoing physical examinations during the same period were included as control group. The differences in serum 25-(OH)D, H-FABP, and NT-ProBNP levels were compared, and the correlations between these markers and clinical data were analyzed. Binary logistic regression analysis was used to explore the relationships between these markers and the occurrence of early myocardial injury. Receiver operating characteristic (ROC) curve analysis was employed to assess the diagnostic value of these markers for early myocardial injury in AECOPD patients.
    Results The forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), the ratio of FEV1 to FVC (FEV1/FVC), and arterial partial pressure of oxygen pa(O2)levels in the AECOPD group were lower than those in the control group, while the arterial partial pressure of carbon dioxide pa(CO2) level was higher, with statistically significant differences (P < 0.05). The serum 25-(OH)D levels in the AECOPD group and the injury group were lower than those in the control group and the non-injury group, respectively, while the H-FABP and NT-ProBNP levels were higher, with statistically significant differences (P < 0.05). In AECOPD patients, serum 25-(OH)D was positively correlated with FEV1, FVC, FEV1/FVC, and pa(O2), and negatively correlated with pa(CO2) (P < 0.05). In contrast, H-FABP and NT-ProBNP were negatively correlated with FEV1, FVC, FEV1/FVC, and pa(O2), and positively correlated with pa(CO2) (P < 0.05). Binary Logistic regression analysis revealed that 25-(OH)D, H-FABP, and NT-ProBNP were related influencing factors for early myocardial injury in AECOPD patients (P < 0.05). ROC curve analysis showed that the areas under the curve (AUCs) for evaluating myocardial injury status based on 25-(OH)D, H-FABP, and NT-ProBNP values were 0.814, 0.959, and 0.837, respectively. The AUC of their combination was 0.983, with a sensitivity of 97.06% and a specificity of 80.77%.
    Conclusion During early myocardial injury in AECOPD patients, there is low expression of serum 25-(OH)D and high expression of H-FABP and NT-ProBNP. These three markers are correlated with early myocardial injury and can serve as reference indicators for clinical diagnosis.

     

    • HTML全文
    • 参考文献(17)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回