目的：探讨血心型脂肪酸结合蛋白(H-FABP)、胱抑素C(Cys-C)及一氧化氮(NO)检测对慢性阻塞性肺疾病急性加重(AECOPD)合并肺动脉高压(PAH)的诊断价值。方法：选取50例AECOPD合并PAH患者为PAH组,50例单纯AECOPD患者为AECOPD组,45例健康体检者为健康组。检测三组血H-FABP、Cys-C及NO水平,观察不同肺动脉压患者H-FABP、Cys-C及NO水平差异,分析各指标对AECOPD合并PAH的诊断价值。结果：PAH组患者血H-FABP、Cys-C水平显著高于AECOPD组和健康组,血NO则低于AECOPD组和健康组(P<0.05)。不同肺动脉压组患者血H-FABP、Cys-C及NO水平存在统计学差异(P<0.05)。血H-FABP、Cys-C及NO诊断AECOPD合并PAH的灵敏度为82.0%、72.0%、90.0%,特异度为83.2%、84.2%、80.0%。三项指标联合检测的灵敏度显著高于各指标单独检测(P<0.05),特异度则与各指标单独检测无统计学差异(P>0.05)。PAH患者血H-FABP、Cys-C与NO均呈显著负相关,血H-FABP、Cys-C之间呈正相关(P<0.05)。结论：血H-FABP、Cys-C及NO在AECOPD患者PAH发生和发展过程中具有重要作用,三者联合检测对AECOPD合并PAH的诊断具有一定参考价值。

Objective: To investigate the diagnostic value of heart-type fatty acid binding protein (H-FABP), cystatin C (Cys-C) and nitric oxide (NO) for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined pulmonary arterial hypertension (PAH). Methods: 50 patients with AECOPD combined PAH were enrolled as PAH group, 50 patients with simple AECOPD as AECOPD group and 45 healthy persons as health group. The levels of H-FABP, Cys-C and NO in the three groups were compared. The differences in H-FABP, Cys-C and NO in patients with different pulmonary artery pressure were observed. The diagnostic value of each indicator for combined PAH of AECOPD was analyzed. Results: The levels of H-FABP and Cys-C in PAH group were significantly higher than those in AECOPD group and the healthy group, while the level of NO was lower than that in the AECOPD group and the healthy group (P<0.05). There were statistically significant differences in H-FABP, Cys-C and NO levels in different pulmonary artery pressure groups (P<0.05). The sensitivity of H-FABP, Cys-C and NO in diagnosing AECOPD combined PAH was 82.0%, 72.0% and 90.0% and the specificity was 83.2%, 84.2% and 80.0%. The sensitivity of combined detection was significantly higher than each index separately (P<0.05), while the specificity was not significantly different from each index separately (P>0.05). H-FABP and Cys-C were significantly negatively correlated with NO in PAH patients, and H-FABP was positively correlated with Cys-C (P<0.05). Conclusion: The H-FABP, Cys-C and NO play an important role in the occurrence and development of patients with AECOPD combined PAH, and the combined detection of H-FABP, Cys-C and NO has a certain reference value for diagnosis of AECOPD combined PAH.