Relationship Between Mean Platelet Volume And Chronic Obstructive Pulmonary Disease With Pulmonary Heart Disease

Objectives The aim was to investigate the relationship between mean platelet volume(MPV)and chronic obstructive pulmonary disease(COPD)with chronic pulmonary heart disease,to help clinicians evaluate the risk of COPD patients complicated with pulmonary heart disease,provide basis for clinical diagnosis and therapeutic effect observation of the disease,and judge the disease development and prognosis of patients as soon as possible.Methods According to the inclusion and exclusion criteria,330 patients with chronic obstructive pulmonary disease who were hospitalized in the Department of Respiratory Medicine and Critical Care Medicine of the Affiliated Hospital of North China University of Science and Technology from October 2019 to December 2021 were selected as the research objects,and the included patients were divided into the pure COPD group(n=227)and COPD combined with cor pulmonale group(n=103).Clinical data including general clinical data,laboratory test indicators,blood gas analysis and echocardiography were collected.The clinical data of the single COPD group,the COPD combined with cor pulmonale group,and the subgroups of COPD combined with cor pulmonale(compensatory stage group,decompensatory stage group)were analyzed by univariate comparison.Multivariate binary logistic regression was used to analyze the independent risk factors of COPD patients with cor pulmonale.The receiver operating characteristic(ROC)curve was used to screen the optimal cut-off point of MPV,and the sensitivity,specificity and Kappa values were used to evaluate the authenticity and reliability of MPV in the risk assessment of COPD patients with pulmonary heart disease.Results 1 Univariate analysis: eject fraction,pulmonary artery pressure,partial carbon dioxide pressure,oxygenation index,MPV,platelet volume distribution width(PDW),platelet,neutrophil to lymphocyte ratio(NLR),total cholesterol(TC),triglyceride(TG)and D-dimer between the pure COPD group and COPD combined with cor pulmonale group were compared,and the differences were statistically significant(P<0.05).There was no significant difference in gender,age,body mass index(BMI),smoking history,drinking history,diabetes,pulmonary artery diameter,oxygen partial pressure,white blood cell,hemoglobin,red blood cell distribution width(RDW),uric acid and hypersensitive Creactive protein(hs-CRP)between the two groups(P>0.05).2 Multivariate analysis:pulmonary artery pressure,MPV and PDW were independent risk factors for COPD patients with cor pulmonale(P<0.05),while ejection fraction,partial pressure of carbon dioxide,oxygenation index,platelet,NLR,TC,TG and D-dimer were not independent risk factors for COPD patients with cor pulmonale(P>0.05).3 There was no statistical difference in MPV between the two subgroups in the compensated period and the decompensated period(P>0.05).4 ROC curve analysis: according to ROC curve analysis,the results show that the area under curve(AUC)of MPV in predicting COPD patients with pulmonary heart disease was 0.819,the sensitivity was 81.6%,and the specificity was64.3%,indicating that MPV had certain predictive ability for COPD patients with pulmonary heart disease.5 MPV effect evaluation: according to the maximum point of yoden index,the optimal cut-off value of MPV for prediction of COPD patients with pulmonary heart disease was selected,but the consistency between the predicted results and the actual results was low(Kappa=0.394),manifesting that the clinical application value of MPV prediction alone was limited.Conclusions 1 MPV is associated with COPD combined with cor pulmonale.Elevated MPV levels are associated with higher risk of COPD combined with cor pulmonale.2MPV has a certain predictive ability in COPD patients complicated with cor pulmonale,but the clinical utility of its use alone is limited.3 There is no difference in MPV between compensated stage and decompensated stage in COPD patients with cor pulmonum.Figure 1;Table 12;Reference 191...