老年COPD急性加重期患者肌钙蛋白NT-pro-BNP水平与左心室射血分数正常型心力衰竭发生的关系研究

doi:10.3969/j.issn.1006-6233.2025.03.022

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摘要 目的: 分析老年慢性阻塞性肺病(COPD)急性加重期患者血清肌钙蛋白I(cTnI)、N-末端B型脑钠肽前体(NT-pro-BNP)水平与左心室射血分数正常型心力衰竭发生的关系。方法: 以2020年7月至2024年7月本院收治的191例COPD急性加重期患者为研究对象,依据其是否并发射血分数正常型心力衰竭患者为心力衰竭组(n=103)和单纯COPD组(n=88)。所有研究对象均在入院后测定血清cTnI、NT-pro-BNP水平,以受试者特征工作曲线(ROC)分析血清cTnI、NT-pro-BNP水平对老年COPD急性加重期患者并发左心室射血分数正常型心力衰竭的预测价值。结果: 相比于单纯COPD组,心力衰竭组的血清cTnI、NT-pro-BNP水平明显升高(P<0.05)。ROC曲线显示,cTnI、NT-pro-BNP联合预测老年COPD急性加重期并发左心室射血分数正常型心力衰竭的曲线下面积(AUC)为0.930,灵敏度为81.55%,特异性为94.32%,cTnI、NT-pro-BNP单独预测的AUC分别为0.685、0.650,灵敏度分别为45.63%、69.90%,特异度分别为84.09%、63.64%,联合预测效能优于各指标单独预测(P<0.05)。结论: 老年COPD急性加重期患者的血清cTnI、NT-pro-BNP水平与左心室射血分数正常型心力衰竭的发生密切相关,早期测定cTnI、NT-pro-BNP水平可为老年COPD急性加重期患者左心室射血分数正常型心力衰竭的发生提供一定的预测价值,以指导临床采取积极的防治措施。

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	范君
	李莉
	周茂松

关键词 ：慢性阻塞性肺病, 急性加重期, 左心室射血分数正常型心力衰竭, 肌钙蛋白I, N-末端B型脑钠肽前体

Abstract：Objective: To analyze the correlation between levels of serum cardiac troponin I (cTnI) and N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) and occurrence of heart failure with preserved left ventricular ejection fraction (HFpEF) in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: Totally 191 AECOPD patients in the hospital from July 2020 to July 2024 were enrolled. According to the presence or absence of HFpEF, they were divided into the heart failure (HF) group (n=103) and simple COPD group (n=88). Serum cTnI and NT-pro-BNP levels were measured in all subjects after admission. Receiver operating characteristic curve (ROC) was plotted to analyze the predictive value of serum cTnI and NT-pro-BNP levels for the occurrence of HFpEF in elderly patients with AECOPD. Results: Compared with the simple COPD group, the levels of serum cTnI and NT-pro-BNP in the HF group were significantly increased (P<0.05). ROC curve indicated that the area under the curve (AUC) of combination of cTnI and NT-pro-BNP in predicting HFpEF was 0.930, with a sensitivity of 81.55% and a specificity of 94.32%. The AUC of cTnI and NT-pro-BNP was 0.685 and 0.650, and the sensitivities were 45.63% and 69.90%, and the specificities were 84.09% and 63.64% respectively. The efficiency of combined prediction was better than that of each indicator alone (P<0.05). Conclusion: The levels of serum cTnI and NT-pro-BNP in elderly patients with AECOPD are closely related to the occurrence of HFpEF. Early determination of cTnI and NT-pro-BNP can provide a certain predictive value for the occurrence of HFpEF in elderly patients with AECOPD, aiming to guide clinical positive prevention and treatment measures.

Key words： Chronic obstructive pulmonary disease Acute exacerbation Heart failure with preserved left ventricular ejection fraction Cardiac troponin I N-terminal pro-B-type brain natriuretic peptide

基金资助:2020年度安徽省自然科学基金项目,(编号:2008085QH400)

通讯作者: 周茂松

引用本文:

范君, 李莉, 周茂松. 老年COPD急性加重期患者肌钙蛋白NT-pro-BNP水平与左心室射血分数正常型心力衰竭发生的关系研究[J]. 河北医学, 2025, 31(3): 476-480.
FAN Jun, LI Li, ZHOU Maosong. Correlation between Levels of Cardiac Troponin and NT-pro-BNP and Occurrence of Heart Failure with Preserved Left Ventricular Ejection Fraction in Elderly Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease. HeBei Med, 2025, 31(3): 476-480.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.03.022 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I3/476

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