evrazkarЕвразийский Кардиологический ЖурналEurasian heart journal2225-16852305-0748Евразийская ассоциация кардиологов10.38109/2225-1685-2015-4-26-31evrazkar-5652Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL PAPERSРОЛЬ N-КОНЦЕВОГО ПРЕДШЕСТВЕННИКА НАТРИЙУРЕТИЧЕСКОГО ПЕПТИДА C-ТИПА КАК ДИАГНОСТИЧЕСКОГО МАРКЁРА ЛЁГОЧНОЙ ГИПЕРТЕНЗИИ У БОЛЬНЫХ ХОБЛTHE ROLE OF N-TERMINAL PRO-C-TYPE NATRIURETIC PEPTIDE AS A DIAGNOSTIC BIOMARKER OF PULMONARY HYPERTENSION IN COPD PATIENTSГайнитдиноваВ. В.GaynitdinovaV. V.noemail@neicon.ruШарафутдиноваЛ. А.SharafutdunovaL. A.noemail@neicon.ruАвдеевС. Н.AvdeevS. N.noemail@neicon.ruГБОУ ВПО «Башкирский государственный медицинский университет» Минздрава РоссииРоссияBashkir State Medical UniversityRussian FederationГБОУ ВПО «Башкирский государственный университет»РоссияBashkir State UniversityRussian FederationФГУ НИИ пульмонологии ФМБА РоссииРоссияPulmonology Research InstituteRussian Federation201530122015042631Copyright © Гайнитдинова В.В., Шарафутдинова Л.А., Авдеев С.Н., 20152015Гайнитдинова В.В., Шарафутдинова Л.А., Авдеев С.Н.Gaynitdinova V.V., Sharafutdunova L.A., Avdeev S.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.heartj.asia/jour/article/view/5652

Актуальность. Согласно литературным источникам, данные о диагностической значимости N-концевого предшественника натрийуретического пептида С-типа (NT-proCNP) для прогнозирования лёгочной гипертензии (ЛГ) у пациентов с ХОБЛ немногочисленны. Цель. Определить концентрацию NT-proCNP у больных ХОБЛ и оценить его диагностическую ценность для прогнозирования ЛГ при ХОБЛ. Материал и методы. В исследование были включены 47 пациентов с ХОБЛ (GOLD II-IV, в возрасте 59,49±0,63 лет, с длительностью заболевания 13,7±0,63 лет, индексом курения 23,09±0,93 пачек/лет). Концентрацию NT-proСNP в сыворотке крови определяли с помощью ИФА (тест Biomedica Medizin produkte GmbH&Co KG, Австрия). Максимальное систолическое давление в лёгочной артерии (СДЛА) оценивали с помощью непрерывно-волновой допплерографии. Результаты. Концентрации NT-proCNP были значительно выше у пациентов с ХОБЛ с ЛГ (СДЛА 40-55 мм рт. ст., n=16) или тяжелой ЛГ (≥55 мм рт. ст., СДЛА, n=10), чем у пациентов без ЛГ (СДЛА <40 мм рт. ст., n=21): 4.14±0.51 пг/мл, 5,26±0,21 пг/мл и 1,42±0,03 пг/мл (р<0,001), соответственно. Выявлена значимая корреляционная взаимосвязь уровня СДЛА с концентрацией NT-proCNP (r=0,53, p<0,05) и высокая диагностическая значимость определения Nt-proCNP для прогнозирования тяжёлой (AUC 0,932) и нетяжёлой (AUC 0,928) ЛГ у больных ХОБЛ. Выводы. Настоящее исследование показывает, что сывороточный уровень NT-proCNP значительно повышен у больных ХОБЛ с ЛГ и может быть использован в качестве неинвазивного специфического биомаркёра для прогнозирования ЛГ при ХОБЛ.

Objective. Available data on the diagnostic value of determination of the concentration N-terminal pro-C-type natriuretic peptide (Nt-proCNP) to predict pulmonary hypertension (PH) in patients with COPD are few. Aim. To determine the concentration of NT-proCNP in COPD patients and evaluate its diagnostic value for the prediction of PH in COPD. Methods. The study involved 47 patients with COPD (GOLD II-IV, age 59,49±0,63 years, disease duration 13,7±0,63 years, smoking history 23,09±0,93 packs/years). NT-proCNP concentration in serum was assessed by ELISA technique (test Biomedica Medizinprodukte GmbH & Co KG, Austria). The pulmonary artery systolic pressure (SPAP) was analyzed by using a color-Doppler technique. Results. Concentrations of NT-proCNP were significantly higher in COPD patients with PH (SPAP 40-55 mmHg, n=16) or severe PH (SPAP ≥55 mmHg, n=10) than in patients without PH (SPAP < 40 mmHg, n=21): 4.14±0.51 pg/ml, 5.26±0.21 pg/ml and 1.42±0.03 pg/ml (p<0.001), respectively. A significant correlation was found between the concentration of NT-proCNP and SPAP (r=0.53; p<0.05). The AUC for Nt-proCNP levels to predict PH and severe PH in COPD were 0.928 and 0.932, respectively. Conclusion. The present study shows that the serum levels of NT-proCNP are significantly elevated in COPD patients with PH and can be used as a non-invasive specific biomarker for predicting PH in COPD.

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The authors declare that there are no conflicts of interest present.