喘息性疾病继发肺动脉高压患儿肺功能及血清标志物水平变化的研究

Changes of Pulmonary Function and Serum Markers Expression in Asthmatic Children with Pulmonary Hypertension

摘要: 目的：探讨喘息性疾病继发肺动脉高压患儿肺功能及血清标志物水平变化的研究。方法：选取我院2017-09至2019-04间住院部收治的90例喘息性疾病患儿，根据是否合并肺动脉高压将患儿分为肺动脉高压组和非肺动脉高压组，分别纳入30例和60例患儿。对两组患儿肺功能：分钟通气量(minute volume, MV)、公斤潮气量(tidal volume per kilogram, VT/kg)、吸呼比[the ratio of inspiratory time (TI) to expiration time (TE), TI/TE]、达峰时间[the ratio of time to peak tidal expiratory fow (TPEF) to total expiratory time (TE), TPEF/TE]、达峰容积比[the ratio of volume to peak expiratory fow (VPEF) to total erpiratory volume (VE), VPEF/VE]进行检测和比较。对两组患者的血清C-反应蛋白、血清淀粉样蛋白A、降钙素原、脑尿钠肽、D-二聚体进行检测和比较。结果：肺动脉高压组MV、VT/Kg、TI/TE、TPTE/TE、VPEF/VE水平低于非肺动脉高压组且差异均有统计学意义(P < 0.05)。肺动脉高压组降钙素原、脑尿钠肽水平高于非肺动脉高压组且差异均有统计学意义(P < 0.05)。结论：喘息性疾病均存在不同程度小气道阻塞障碍。肺动脉高压组肺功能下降程度比非肺动脉高压组改变明显，肺动脉高压组的肺功能下降程度显著。肺动脉高压组降钙素原、脑尿钠肽、D-二聚体水平明显高于非肺动脉高压组，某些生物学标记物水平与肺高压的发病风险和病情进展存在相关性。

Abstract: Objective: To investigate the changes of pulmonary function and serum inflammatory factors in asthmatic children with pulmonary arterial hypertension. Methods: To study the changes of pulmonary function and serum markers in asthmatic diseases with pulmonary hypertension in children. Methods: 90 cases of asthmatic diseases were selected in respiratory department between September 2017 and April 2019. According to the systolic pressure of pulmonary artery was ≥ 25 mmhg or not, the children were divided into 30 cases of PAH group and 60 cases of non pulmonary arterial hypertension group. The lung function was measured by tidal inhalation, and compared minute volume, tidal volume per-kilogram, the ratio of inspiratory time to expiration time, the ratio of time to peak tidal expiratory fow to total expiratory time, the ratio of volume to peak expiratory fow to total erpiratory volume between two group compared Serum CRP, SAA and D-dimer and Brain natriuretic peptide, and Procalcitonin between the two groups. Results: The levels of MV, VT/kg, Ti/TE, TpTe/TE and vptef/VE in the pulmonary arterial hypertension group were lower than those of the non pulmonary arterial hypertension group (P < 0.05). The levels of PCT and BNP in pulmonary arterial hypertension group were higher than those of non pulmonary arterial hypertension group (P < 0.05). Conclusion: There are different degrees of small airway obstruction in asthmatic diseases. The degree of pulmonary function decline in pulmonary arterial hypertension group was more obvious than that in non pulmonary arterial hypertension group. The levels of serum inflammatory factors (PCT, BNP) in the pulmonary arterial hypertension group were significantly higher than those in the non pulmonary arterial hypertension group.