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| 慢性阻塞性肺疾病急性加重期血清同型半胱氨酸、D-二聚体、N末端脑钠肽前体和心肌肌钙蛋白的临床意义 【摘要】 目的 探讨检测血清同型半胱氨酸（Hcy）、D-二聚体、N末端脑钠肽前体(NT-proBNP)和心肌肌钙蛋白(cTnI)在慢性阻塞性肺疾病急性加重期患者中的临床意义。方法 选取我院收治的慢性阻塞性肺疾病急性加重期患者68例为AECOPD组，同期我院健康体检患者68 例为对照组，AECOPD组治疗前后及对照组均检测Hcy、D-二聚体、NT-proBNP和cTnI。结果 ①AECOPD治疗前后组患者的Hcy、D-二聚体、NT-proBNP和 cTnI相比于正常对照组均升高（P＜0.05），且AECOPD治疗前Hcy、D-二聚体、NT-proBNP和 cTnI明显高于AECOPD治疗后组（P＜0.05）。②AECOPD 患者的Hcy与D-二聚体、NT-proBNP和cTnI分别呈正相关。结论 COPD患者存在高凝状态，易产生肺血管微血栓，引起肺动脉高压，导致心脏损伤；Hcy通过激活凝血系统，抑制抗凝血物质活性等机制，参与到COPD心脏损害的过程之中。 【关键词】 慢性阻塞性肺疾病；急性加重期；同型半胱氨酸；D-二聚体；N末端脑钠肽前体；心肌肌钙蛋白 Clinical value of serum homocysteine, D-dimer,N-terminal pro-brain natriuretic peptide and cardiac troponin I in patients with AECOPD 【Abstract】 Objective To investigate the clinical significance of detecting serum homocysteine (Hcy), D-dimer (D-D),N-terminal pro-brain natriuretic peptide(NT-proBNP) and cardiac troponin I(cTnI) in patients with AECOPD.Methods 68 AECOPD patients in our hospital were selected as the AECOPD group. 68 healthy people was randomly selected from the same period as the control group. Hcy,D-D,NT-proBNP and cTnI were detected in the all groups. Results ①The value of Hcy, D-D, NT-proBNP and cTnI was higher in the AECOPD group than in the control group(P<0.05); There were significant differences in Hcy,D-D,NT-proBNP and cTnI levels before and after treatment, the value of Hcy, D-D, NT-proBNP and cTnI before treatment was higher than after treatment;( P<0.05)②plasma Hcy and D-D, NT-proBNP and cTnI present a positive correlation in AECOPD patients(P<0.05).Conclusion There is high coagulation state in COPD patients, which can lead pulmonary vascular microthrombi, causing pulmonary hypertension and leading cardiac injury. By activating coagulation system and inhibiting the activity of anticoagulant substances, Hcy play a role in the process of heart damage of COPD. 【Key words】 chronic obstructive pulmonary disease; acute exacerbation stage; homocysteine; D-dimer; N-terminal pro-brain natriuretic peptide;cardiac troponin I  |
