Clinical Characteristics Of AECOPD Combined With CHD And The Relationship Between Renal Function And Cardiopulmonary Function

Objective:By comparing the clinical data of patients with AECOPD combined with CHD,simple AECOPD and simple CHD,analyze the clinical characteristics and influencing factors of AECOPD combined with CHD.To explore the relationship between serum creatinine level,e GFR and cardiopulmonary function in patients with AECOPD and CHD.Methods:A total of 125 patients with AECOPD complicated with CHD treated in our hospital from January 2018 to June 2022 were collected as research objects,while 138 patients with simple AECOPD and 130 patients with simple CHD were the control groups.The clinical data of all subjects were collected,and the general datas and laboratory indicators of the three groups were compared,the influencing factors of AECOPD complicated with CHD were analyzed by stepwise multi-factor Logistic regression.The influencing factors were then stratified to explore the interaction between serum creatinine levels and the above indexes on the risk of AECOPD complicated with CHD.Spearman correlation analysis was used to explore the correlation between serum creatinine level,e GFR and cardiopulmonary function in patients with AECOPD and CHD.Results:1.Compared with patients with simple AECOPD and simple CHD groups,patients with AECOPD and CHD were older and had a higher prevalence of heart failure（P<0.05）.The BMI,prevalence of hypertension and type 2 diabetes in AECOPD combined with CHD group was higher than that in simple AECOPD group（P<0.05）,the smoking index and male proportion were higher than that in simple CHD group,and the prevalence of hyperlipidemia and BMI were lower than that in simple CHD group（P<0.05）.2.Compared with simple CHD group,there were no significant differences in inflammation and coagulation indexes of AECOPD combined with CHD group.Leukocyte,neutrophil count,neutrophil percentage,mean red cell volume（MCV）,red cell distribution width（RDW）,neutrophil/lymphocyte ratio（NLR）,monocyte/lymphocyte ratio（MLR）,mean platelet volume/lymphocyte（MPVLR）,RDW and MCV product,FIB and DD dimer levels in AECOPD combined with CHD group were significantly higher than those of CHD alone（P<0.05）.3.Compared with simple AECOPD and simple CHD groups,the serum creatinine level of AECOPD combined with CHD group was increased,and the levels of e GFR,total cholesterol,non-high-density lipoprotein,LDL-C,apolipoprotein B and LHR were decreased,with statistical significance（P<0.05）.Compared with simple AECOPD group,the level of uric acid/creatinine was decreased in AECOPD combined with CHD group.Compared with simple CHD group,prealbumin,ALT,AST,ALP,triglyceride,TG/HDL-C and the index of Ty G were decreased,while the levels of urea and lipoprotein A were increased（P<0.05）.4.Compared with simple AECOPD group,troponin T level in AECOPD combined with CHD group was increased,EF and FS were decreased,the difference was statistically significant（P<0.05）,while NT-pro BNP level was not significantly different（P>0.05）.Compared with simple CHD group,troponin T and NT-pro BNP levels were increased,EF and FS were decreased,and the difference was statistically significant（P<0.05）.5.Compared with simple AECOPD group,the FEV₁%and FEV₁/FVC of AECOPD combined with CHD group were increased,while the Pa CO₂was decreased,the difference was statistically significant（P<0.05）,but there were no significant differences in Pa O₂and oxygenated lung work index（P>0.05）.6.Age,prevalence of heart failure,serum creatinine and non-high-density lipoprotein levels were the influencing factors of AECOPD combined with CHD（P<0.05）.7.After adjusting for age,non-HDL levels,prevalence of heart failure,and history of hypertension,increased serum creatinine levels were associated with an increased risk of AECOPD combined with CHD in subgroups with aged 60-79 years,non-HDL>3.40mmol/L and hypertension（P<0.05）.Interaction analysis showed no significant interaction between serum creatinine level and age,non-high-density lipoprotein level,prevalence of heart failure,and history of hypertension（P>0.05）.8.Serum creatinine level of AECOPD combined with CHD group was positively correlated with troponin T and NT-pro BNP levels（r=0.394,0.366,P<0.001）,and negatively correlated with EF and FS（r=-0.255,-0.231,P<0.05）.There were no significant differences in its correlations with FEV₁%,FEV₁/FVC,GOLD grading,Pa O₂,Pa CO₂,hypoxia and CO₂retention（P>0.05）.The e GFR was negatively correlated with troponin T and NT-pro BNP levels（r=-0.422,-0.400,P<0.001）,and positively correlated with EF and FS（r=0.236,0.228,P<0.05）.There were no significant differences in its correlations with FEV₁%,FEV₁/FVC,GOLD grading,Pa O₂,Pa CO₂,hypoxia or CO₂retention（P>0.05）.Conclusions:1.Patients with AECOPD complicated with CHD had older age,higher prevalence rate of hypertension,diabetes and heart failure,decreased plasma lipoprotein level,and significantly impaired cardiac systolic function and renal excretion function.2.Age,prevalence of heart failure,serum creatinine and non-high-density lipoprotein levels were the influencing factors for AECOPD complicated with CHD,and serum creatinine level was an independent influencing factor for AECOPD complicated with CHD.3.The level of serum creatinine and e GFR in patients with AECOPD complicated with CHD were related to myocardial injury and the decrease of cardiac systolic function,but not to pulmonary function.