慢性阻塞性肺疾病合并肺动脉高压患者血清Cys-C水平变化及意义

摘要

目的 探讨慢性阻塞性肺疾病(慢阻肺)合并肺动脉高压患者血清胱抑素-C(Cys-C)水平变化及意义.方法 选择慢阻肺患者157例作为慢阻肺组,分为肺动脉压增高亚组68例,肺动脉压正常亚组89例,健康体检者50例作为对照组,分别对比一般临床资料、血清Cys-C水平、血气分析结果.结果 慢阻肺组血清Cys-C水平明显高于对照组(1.06 ±0.41/0.84±0.27),差异有统计学意义(P＜0.001);肺动脉压增高亚组血清Cys-C水平明显高于肺动脉压正常亚组(1.33±0.35/0.97±0.32),差异有统计学意义(P ＜0.001);血清Cys-C水平与肺动脉压呈显著正相关(r=0.604,P＜0.001);受试者工作(ROC)曲线提示血清Cys-C水平诊断肺动脉高压的敏感度49.2％、特异度79.3％,曲线下面积为0.804.结论 慢阻肺合并肺动脉高压者血清Cys-C水平升高并与肺动脉高压严重程度正相关,检测血清Cys-C水平对于判断肺动脉高压有一定的临床意义.%Objective To investigate the changes and significance of serum cystatin-C (Cys-C) in patients with chronic obstructive pulmonary disease (COPD) complicated with pulmonary hypertension.Methods 157 COPD patients were selected as the COPD group,and then were divided into the pulmonary hypertension subgroup (n =68) and the normal subgroup (n =89).50 cases of healthy people were taken as the control group.Their general clinical data,serum Cys-C level and blood gas analysis were compared.Results The serum Cys-C level was significantly higher in the COPD group than in the control group (1.06 ± 0.41/0.84 ± 0.27) (P ＜ 0.001).The serum level of Cys-C was significantly higher in the pulmonary hypertension subgroup than in normal pulmonary artery pressure subgroup (1.33 ±0.35/0.97-±0.32) (P ＜0.001).There was a significant positive correlation between serum Cys-C level and pulmonary artery pressure (r =0.604,P ＜ 0.001).The receiver operating (ROC) curve showed that the sensitivity of serum Cys-C level in the diagnosis of pulmonary hypertension was 49.2％,specificity was 79.3％,and the area under the curve was about 0.804.Conclusion The level of serum Cys-C in patients with COPD was positively correlated with the severity of pulmonary hypertension,and the level of serum Cys-C is of clinical significance in the diagnosis of COPD complicated with pulmonary hypertension.