[1]陈芳玮,梁彦超,廖　亮,等.慢性阻塞性肺疾病患者肠道菌群分布、血浆N端脑钠肽前体和D-二聚体水平及其合并肺栓塞的相关危险因素分析[J].新乡医学院学报,2020,37(11):1065-1068.[doi:10.7683/xxyxyxb.2020.11.015]
　CHEN Fangwei,LIANG Yanchao,LIAO Liang,et al.Distribution of intestinal flora,plasma levels of N-terminal brain natriuretic peptide precursor and D-dimer in patients with chronic obstructive pulmonary disease and the related risk factors of complicating with pulmonary embolism[J].Journal of Xinxiang Medical University,2020,37(11):1065-1068.[doi:10.7683/xxyxyxb.2020.11.015]
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慢性阻塞性肺疾病患者肠道菌群分布、血浆N端脑钠肽前体和D-二聚体水平及其合并肺栓塞的相关危险因素分析
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年11
页码:
1065-1068
栏目:
临床研究
出版日期:
2020-11-05

文章信息/Info

Title:
Distribution of intestinal flora,plasma levels of N-terminal brain natriuretic peptide precursor and D-dimer in patients with chronic obstructive pulmonary disease and the related risk factors of complicating with pulmonary embolism
作者:
陈芳玮1; 梁彦超1; 廖　亮2; 易　展3; 黄　彭1; 刘双柏1
（1.株洲市中心医院呼吸内一科，湖南　株洲　412000；2.贵州医科大学重症监护室，贵州　贵阳　550000；3.湖南中医药大学微生物实验室，湖南　长沙　412000）
Author(s):
CHEN Fangwei1; LIANG Yanchao1; LIAO Liang2; YI Zhan3; HUANG Peng1; LIU Shuangbai1
(1.Department of Respiratory Medicine,Zhuzhou Central Hospital,Zhuzhou 412000,Hunan Province,China;2.Intensive Care Unit,Guizhou Medical University,Guiyang 550000,Guizhou Province,China;3.Microbiology Laboratory,Hunan University of Traditional Chinese Medicine,Changsha 412000,Hunan Province,China)
关键词:
慢性阻塞性肺疾病; 肺栓塞; 肠道菌群; N端脑钠肽前体; D-二聚体; 危险因素
Keywords:
chronic obstructive pulmonary disease; pulmonary embolism; intestinal flora; N-terminal brain natriuretic peptide precursor; D-dimer; risk factor
分类号:
R563
DOI:
10.7683/xxyxyxb.2020.11.015
文献标志码:
A
摘要:
目的　探讨慢性阻塞性肺疾病（COPD）患者肠道菌群分布、血浆N端脑钠肽前体（NT-proBNP）和D-二聚体（D-dimer）水平及COPD合并肺栓塞（PE）相关危险因素。方法　选择2017年1月至2019年12月株洲市中心医院呼吸内科收治的80例COPD患者为研究对象，根据是否合并PE将患者分为观察组（n=40，合并PE）和对照组（n=40,不合并PE）。比较2组患者肠道菌群分布情况及血浆NT-proBNP、D-dimer水平；通过单因素分析和logistic回归分析COPD合并PE的相关危险因素。结果　2组患者肠道中乳杆菌、拟杆菌、肠球菌及梭杆菌数量比较差异无统计学意义（P>0.05）；观察组患者肠道中双歧杆菌数量显著低于对照组，肠杆菌数量显著高于对照组（P<0.05）。观察组患者血浆NT-proBNP、D-dimer水平均显著高于对照组（P<0.05）。COPD合并PE与患者血浆D-dimer水平、BNP水平升高、既往6周内手术史、卧床情况有关（P<0.05），与患者的性别、年龄、吸烟、低血压史、高血压史、糖尿病史、脑血管疾病史无关（P>0.05）。Logistic回归分析结果显示，D-dimer水平（≥500 μg·L-1）、NT-proBNP水平升高、既往6周内有手术史以及卧床情况（≥7 d）是COPD合并PE的独立危险因素（P<0.05）。结论　COPD合并PE患者肠道菌群分布失衡、血浆NT-proBNP、D-dimer水平升高。D-dimer水平（≥500 μg·L-1）、NT-proBNP水平升高、既往6周内有手术史以及卧床情况（≥7 d）是COPD患者合并PE的独立危险因素。
Abstract:
Objective　To explore the distribution of intestinal flora and the plasma levels of N-terminal brain natriuretic peptide precursor (NT-proBNP) and D-dimer in patients with chronic obstructive pulmonary disease (COPD) and analyze the related risk factors of COPD complicated with pulmonary embolism (PE).Methods　Eighty COPD patients in the Department of Respiratory Medicine of Zhuzhou Central Hospital from January 2017 to December 2019 were selected as research objects.The patients were divided into observation group(n=40,COPD complicated with PE) and control group(n=40,COPD without PE) according to whether the patients combined with PE.The distribution of intestinal flora and the plasma levels of NT-proBNP,D-dimer were compared between the two groups.The risk factors of COPD complicated with PE were analyzed by single factor analysis and logistic regression analysis.Results　There was no significant difference in the number of Lactobacillus,Bacteroides,Enterococcus and Fusobacterium in intestinal tract of patients between the two groups (P>0.05).The number of Bifidobacterium in intestinal tract of patients in the observation group was significantly lower than that in the control group (P<0.05),and the number of Enterobacter in intestinal tract of patients in the observation group was significantly higher than that in the control group (P<0.05).The plasma levels of NT-proBNP and D-dimer of patients in the observation group were significantly higher than those in the control group (P<0.05).The COPD complicated with PE was related to the increase of plasma D-dimer，NT-proBNP levels,operation history within 6 weeks,and long-term bed rest (P<0.05),but not related to the gender,age,smoking,hypotension history,hypertension history,diabetes history and cerebrovascular disease history (P>0.05).Logistic regression analysis showed that the D-dimer level (≥500 μg·L-1),increase of NT-proBNP level,operation history within 6 weeks and long-term bed rest (≥7 days) were independent risk factors of COPD complicated with (P<0.05).Conclusion　The intestinal flora distribution of COPD patients combined with PE is unbalanced,and the plasma levels of NT-proBNP,D-dimer increased.The D-dimer level (≥500 μg·L-1),increase of NT-proBNP level,operation history within 6 weeks and long-term bed rest (≥7 days) are the independent risk factors for COPD complicated with PE.

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更新日期/Last Update: 2020-11-05