The Assessment Value Of Respiratory Score Combined With Serum Marker On COPD With PH

Objective To explore the assessment value of the respiratory scoring system includesCAT, mMRC and6MWT in patients with COPD and COPD with pulmonary hypertension; toexplore predictive value of the serum ET-1, VEGF levels in COPD patients with pulmonaryhypertension.Methods We screened70cases diagnosed with COPD from Respiratory and CriticalDiscipline of Ningxia Medical University General Hospital from2012to2013,and devidedthe patients into to two groups of COPD group and group of COPD with pulmonaryhypertension according to pulmonary function, echocardiography and other tests. All patientswere enrolled to complete the CAT, mMRC breathing score and6-minute walk test and werefasted venous blood collected serum ET-1and VEGF which were measured by enzyme-linkedimmunosorbent assay. We also selected20cases of healthy patients in the same period tomeasure serum ET-1and VEGF in the same way.Result1. Neither CAT nor mMRC has significant correlation with FEV1%pred ofCOPD patients (P>0.05).2. There was statistically significant difference between COPDgroup and COPD with pulmonary hypertension group according to CAT, mMRC and6MWT（P<0.01）. The area under the ROC curve (AUC) were0.808,0.745and0.744by6MWT,CAT score and mMRC grading system to determine whether COPD with pulmonaryhypertension. The cut-off point is21to diagnose COPD with PH by using CAT scale.3. CATScale and6MWT was negatively correlated (r=-0.623, P <0.01), mMRC negativelycorrelated with the6MWT (r=-0.514, P=0.000). CAT and mMRC positively correlated (r=0.492, P=0.000).4. The serum ET-1of COPD with pulmonary hypertension patients (109.28±8.13pg/ml) was significantly higher than the COPD group (90.41±5.07pg/ml)and healthy controls (35.29±6.12pg/ml).The difference was statistically significant (F=66.942, P <0.05). The serum VEGF of COPD with pulmonary hypertension patients (1075.32±45.21pg/ml) was significantly lower than that in the COPD group (1261.31±62.54pg/ml) but was higher than that in the healthy controls (506.21±30.63pg/ml), the differencewas statistically significant (F=58.752, P <0.05).Conclusion1.There was no significant correlation between CAT, mMRC respiratoryseverity scoring system and lung function in COPD patients.2. CAT, mMRC and6MWT canbe used to predict the possibility of pulmonary hypertension risk.6MWD is highest accuratemerger for screening PH from COPD patients,followed by CAT scale. The cut-off point is21to determine the diagnostic risk of COPD with PH by using CAT scale.3. Serum ET-1, VEGFlevels in COPD with pulmonary hypertension group were significantly different from COPDgroup. ET-1, VEGF may be involved in the formation of pulmonary hypertension in COPD.