Clinical Value On Prognosis Of Chronic Obstructive Pulmonary Disease By CT Scan-measured Pulmonary Artery To Aorta Ratio

ObjectivesTo study the clinical significance of the dynamic ratio of pulmonary artery to aorta(PA: A)in predicting the prognosis of patients with chronic obstructive pulmonary disease(COPD).Methods90 patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)admitted to the respiratory department,Gongli Hospital,Pudong new area,Shanghai,China,from October 2014 to October 2015 were enrolled.The PA: A ratio was stratified according to the chest CT scan.Patients with PA: A ratio?1 were divided into group A(n=45)and patients with PA: A>1 were divided into group B(n =45).The clinical data of the two groups were measured at admission,at discharge,6 months after discharge,and 12 months after discharge.Echocardiography was performed and CAT scores were recorded at the same time.Pulmonary function,6-minute walking distance(6MWT),arterial blood gas analysis were recorded in the two groups.IL-6,IL-21,TNF-? and NT-pro BNP were measured by routine blood test.The number of acute exacerbations and deaths were recorded within 12 months.ResultsThe times of acute exacerbation in group B were higher than that in group A(P <0.05).The mortality rate in group B was significantly higher than that in group A within 1 year.There were significant differences in the PA: A ratio,NT-pro BNP and PASP between the two groups(P <0.05),while the B group was significantly higher than the A group.There were no significant differences in p H,Pa O2,Pa CO2,WBC,hs-CRP,IL-6,IL-21,TNF-?,FEV1%,6MWT and CAT scores(P>0.05).After a year of follow-up,there were significant differences in PA: A ratio,NT-pro BNP,IL-6,IL-21,TNF-?,PASP,FEV1%,p H,Pa O2,Pa CO2,6MWT and CAT scores between the two groups(P <0.05)while WBC,hs-CRP were not statistically significant(P> 0.05).There was a positive correlation between PA:A ratio,Pa CO2,NT-pro BNP,PASP and CAT scores(P <0.05),and negatively correlated with Pa O2,6MWT and FEV1%(P <0.05).Group B is higher than group A.ConclusionCT scan-measured PA: A ratio can be used as an important index to predict the prognosis of patients with COPD.