目的 探讨血清C-反应蛋白(CRP)、磷酸肌酸激酶同工酶(CK-MB)和B型利钠肽(BNP)在慢性阻塞性肺病(COPD)急性发作期和治疗缓解期浓度变化及临床意义.方法 测定90例COPD患者急性发作期、治疗缓解期血清CRP、CK-MB和BNP水平和动脉血氧分压(PaO2),60例健康体检者血清CRP、CK-MB和BNP水平.结果 缓解期和急性期COPD患者血清CRP、CK-MB和BNP水平与正常对照组比较差异均有统计学意义(均P＜0.05),且急性期COPD患者血清CRP、CK-MB和BNP水平与缓解期COPD患者比较差异均有统计学意义(均P＜0.05);急性期COPD患者PaO2与缓解期COPD患者比较差异有统计学意义(P＜0.05);相关性分析显示,COPD急性期患者CRP与CK-MB、BNP之间及CK-MB与BNP之间呈正相关(P＜0.05),PaO2与CRP、CK-MB、BNP之间呈负相关(P＜0.05),而在COPD缓解期CRP、CK-MB、BNP、PaO2各指标之间无相关性(P ＞0.05).结论 COPD急性发作期血清CRP浓度高,机体存在低氧血症、心肌受损和右心室功能障碍;联合检测CRP、CK-MB和BNP可以为COPD的诊断、预防和治疗提供可靠的评价指标.%Objective To investigate the changes of serum C-reactive protein (CRP), creatine kinase MB isoenzyme (CK- MB) and brain natriuretic peptide (BNP) levels and their clinical significance in patients with chronic obstructive pulmonary disease (COPD) Methods Serum CRP, CK- MB, BNP and PaO2 levels were measured in 90 patients with COPD at acute exacerbation and remission stage, and 60 healthy subjects (controls). Results Serum CRP, CK- MB, and BNP levels of COPD patients in the acute exacerbation and remission stage were higher than those in healthy controls (P＜0.05). Serum CRP, CK- MB,and BNP levels of COPD patients in the acute exacerbation were higher than those in remission stage (P＜0.05). PaO2 levels of COPD patients in the acute exacerbation were significantly lower than those in remission stage (P＜0.05). There was positive correlation of serum CRP ofCOPD patients in acute exacerbation with CK-MB and BNP levels, and positive correlation of serum CK-MB with BNP (r=0.389,0.284,0.268;P=0.000,0.007,0.011). There was negative correlation of PaO2 with serum CRP,CK- MB and BNP (r= - 0.220,- 0.254,- 0.317; P=0.037, 0.016, 0.002) . However, there was no such correlations in COPD patients at remission stages. Conclusion combined detection of serum CRP, CK- MB and BNP can provide reliable indicators for diagnosis, prevention and treatment of COPD.
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