血浆肝素结合蛋白和ST2与慢性阻塞性肺疾病急性加重期并发肺高压及其严重程度的相关因素分析-现代医学

血浆肝素结合蛋白和ST2与慢性阻塞性肺疾病急性加重期并发肺高压及其严重程度的相关因素分析

单位：无锡市锡山人民医院(东南大学附属中大医院无锡分院) 检验科, 江苏无锡 214000

关键词：慢性阻塞性肺疾病急性加重期肺高压肝素结合蛋白生长刺激表达基因2蛋白相关因素

分类号：R563

出版年·卷·期（页码）：2026·54·第五期（763-768）

摘要：

目的：探讨血浆肝素结合蛋白(HBP)和生长刺激表达基因2蛋白(ST2)与慢性阻塞性肺疾病急性加重期(AECOPD)患者并发肺高压(PH)及其严重程度的相关因素。方法：回顾性分析2022年6月至2025年12月期间收治的239例AECOPD患者的临床资料和实验室检查结果。根据患者是否合并PH将其分为单纯AECOPD组和PH组，其中并发PH的患者有125例(52.3%)；并根据平均肺动脉压将PH组患者分为轻中度PH亚组(62例)和重度PH亚组(63例)。比较各组患者血浆HBP和ST2水平差异。采用单因素和多因素Logistic回归分析影响AECOPD并发PH的独立相关因素以及影响AECOPD患者并发不同程度PH的独立相关因素。结果：PH组患者血浆HBP和ST2水平显著高于单纯AECOPD组，重度PH亚组血浆HBP和ST2水平均显著高于轻中度PH亚组(均P<0.05)。多因素Logistic回归分析(校正年龄、性别等混杂因素后)显示，高血压(OR=2.281)、HBP(OR=1.034)及ST2(OR=1.020)是AECOPD患者并发PH的独立相关因素(P<0.05)；而HBP(OR=1.008)和ST2(OR=1.005)是AECOPD患者并发重度PH的独立相关因素(P<0.05)。单因素分析中发现的血压保护作用在多因素模型中无统计学意义。结论：高血压、HBP和ST2是AECOPD患者并发PH的独立相关因素，HBP和ST2也是并发不同程度PH的独立相关因素。本研究结果提示，HBP和ST2可能参与了AECOPD患者PH的发生与进展，但其作为临床辅助评估指标的效能尚未验证，有待后续诊断性研究加以明确。

Objective: To investigate the association of plasma heparin-binding protein(HBP) and growth stimulation expressed gene 2 protein(ST2) with pulmonary hypertension(PH) and its severity in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods:Clinical data and laboratory findings of 239 AECOPD patients admitted from June 2022 to December 2025 were retrospectively analyzed. Patients were divided into a AECOPD group and a PH group according to the presence of PH; 125 patients(52.3%) had PH. Based on mean pulmonary artery pressure, the PH group was further divided into a mild-to-moderate PH subgroup(n=62) and a severe PH subgroup(n=63). Plasma levels of HBP and ST2 were compared among the groups. Univariate and multivariate Logistic regression analyses were used to identify independent factors associated with the occurrence of PH and its severity in AECOPD patients.Results: Plasma levels of HBP and ST2 were significantly higher in patients with pulmonary hypertension(PH) than in those with AECOPD alone, and levels in the severe PH subgroup were significantly higher than those in the mild-to-moderate PH subgroup(all P<0.05). After adjusting for age, sex, and other confounders, multivariable Logistic regression analysis showed that hypertension(OR=2.281), HBP(OR=1.034), and ST2(OR=1.020) were independent factors associated with the occurance of PH in AECOPD patients(all P<0.05). In addition, HBP(OR=1.008) and ST2(OR=1.005) were identified as independent factors associated with severe PH in AECOPD patients(both P<0.05). The protective effect of blood pressure observed in univariate analysis did not remain statistically significant in the multivariable model.Conclusion:Hypertension, HBP, and ST2 are independently associated with the occurance of PH in AECOPD patients, and HBP and ST2 are also independently associated with PH severity. These findings suggest that HBP and ST2 may be involved in the occurance and development of PH in AECOPD. However, their utility as auxiliary clinical assessment indicators has not yet been validated, and further diagnostic studies are warranted to clarify their roles.

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