目的：探讨血清CA125、NT-ProBNP水平与慢性阻塞性肺疾病（COPD）合并肺动脉高压（PAH）的相关性。方法2013年1月至2015年1月慢性阻塞性肺疾病急性加重（AECOPD）患者69例，采用彩色多普勒心脏超声估测肺动脉收缩压，肺动脉收缩压（PASP）≥36mmHg为COPD合并PAH组；PASP<36mmHg作为单纯COPD组。同时根据PASP严重程度分组：以36mmHg≤PASP<50mmHg为轻度PAH组；50mmHg≤PASP<70mmHg为中度PAH组；PASP≥70mmHg为重度PAH组。比较各组间血清CA125、NT-ProBNP水平的差异。结果 COPD合并肺动脉高压组患者血清CA125、NT-ProBNP水平均显著高于未合并肺动脉高压组，分别（63.4±34.8）U/L VS（27.8±15.2）U/L和（1124.4±1016.6）ng/L VS（685.4±441.7）ng/L（P<0.05）。同时，血清CA125水平随着PAH的严重程度增加而逐级升高，NT-ProBNP水平在重症PAH患者较轻中度PAH患者显著升高。相关分析表明，COPD患者血清CA125与NT-ProBNP存在正相关关系（r=0.467，P<0.05）。结论血清CA125、NT-ProBNP水平，可预测COPD患者肺动脉高压的形成及其严重程度，对肺动脉高压的早发现，早治疗具有一定的意义。%ObjectiveTo evaluate the expression and correlation of serum CA125 and NT-ProBNP in chronic obstructive pulmonary disease (COPD)patients complicated with pulmonary arterial hypertension(PAH).MethodsA total of 69 COPD patients with acute exacerbation between Jan 2013 to Jan 2015 were enrolled in this study. Pulmonary arterial systolic pressure(PASP)was determined by Doppler echocardiograph,and the patients were divided into the COPD without PAH group(PASP<36mmHg)and the COPD with PAH group(PASP≥36mmHg). Meanwhile, the patients with PAH were classified according to PASP:mild(36≤PASP<50mmHg);moderate(50≤PASP<70mmHg)and severe(PASP≥70 mmHg). The levels of serum CA125 and NT-ProBNP were compared between groups.ResultsThe levels of CA125 and NT-ProBNP in patients with PAH were significantly higher than those in patients without PAH(63.4±34.8U/L VS 27.8±15.2U/L和1124.4±1016.6ng/L VS 685.4±441.7ng/L, respectively,P<0.05). Meanwhile,the level of serum CA125 increased gradually with the severity of PAH,and the levels of NT-ProBNP in severe group were significantly higher than those in mild and moderate groups. It showed a significantly positive correlation between CA125 and NT-ProBNP (r=0.467,P<0.05).Conclusion The examination of these serum markers in patients with COPD can help to identify PAH in early stage and estimate the severity of PAH. which may be useful for early detection and early treatment.
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