| Objective: To analyze the significance of BNP(brain natriuretic peptide)and PCT(procalcitonin)? CA125(carbohydrate antigen 125)in the clinical diagnosis and prognosis of cor pulmonale.Methods: 200 cases of patients with cor pulmonale admitted to our hospital from January2014 to July 2017 were enrolled.According to the severity of the disease,it was divided into two groups: 100 cases in the acute attack group and 100 cases in the stable group.After admission,all patients were given PCT,CA125 and BNP,cardiac color Doppler ultrasound and liver color Doppler ultrasound examination.The patients in the acute attack group were treated with symptomatic treatment.After the condition was stable,PCT,CA125 and BNP,color Doppler echocardiography and liver color Doppler ultrasound were used to observe the changes of the above indexes.Result:1.In acute attack group,BNP 6102.65±265.85pg/ml,PCT 15.65±3.54ug/L and CA125 28.65 ± 18.41U/ml were significantly higher than those of stable group BNP356.57±25.47pg/ml,PCT 0.39±0.11ug/L and CA125 10.36 ±4.87U/ml,there were significant differences(P< 0.05).At the same time,acute attack group right ventricular diameter 33.17±8.59 mm,PAP 61.62±21.15 mm Hghg group was significantly higher than that of stable right ventricular diameter25.65±5.28mm?PAP40.56±10.65 mm Hg,acute attack group EF(ejection fraction)45.69 ± 8.57% was significantly lower than that in stable group(EF79.39±28.54%),it was significantly different(P< 0.05).Acute attack group before and after the largest oblique diameter of right liver lobe was 11.25±1.25 cm,8.65±1.42 cm diameter of the right hepatic lobe and caudate lobe length 3.65±0.36 cm and stable group of right hepatic lobe maximum oblique diameter of 11.13±1.28 cm,8.62±1.39 cm diameter of the right hepatic lobe and caudate lobe length 3.63±0.33 cm were not significantly different(P> 0.05).2.The BNP 361.33 ± 23.54pg/ml,PCT 0.35 ± 0.11ug/L and CA125 10.32 ±4.79U/ml after treatment in the acute attack group were significantly lower than those before treatment of BNP 6102.65 ± 265.85pg/ml,PCT 15.65 ± 3.54ug/L and CA12528.65 ±,there were significant differences(P< 0.05).After treatment,right ventricular diameter29.34 ± 8.39 mm and PAP41.65 ± 10.32 mm Hg were significantly lower than those before treatment of right ventricular diameter 33.17±8.59 mm and PAP 61.62±21.15 mm Hg.After treatment,EF79.35±28.25% was significantly higher than that before treatment of EF 45.69±8.57%,and the difference was significant(P< 0.05).In the acute attack group,the maximal diagonal diameter of the right lobe was 11.33±1.28 cm,the anteroposterior diameter of the right lobe was 8.38±1.54 cm,the length of the tail of the liver was 3.38±0.41 cm,and the largest oblique diameter of the right lobe of the liver before treatment was 11.25±1.25 cm.The anteroposterior diameter of 8.65±1.42 cm and the length of caudate lobe of 3.65±0.36 cm were not significantly different(P> 0.05).3.In acute attack group,BNP 361.33±23.54pg/ml,PCT 0.35±0.11ug/L and CA12510.32±4.87U/ml and stable group BNP 356.57±25.47pg/ml,PCT 0.39± 0.11ug/L and CA125 10.36±4.79U/ml after treatment were not significantly different(P> 0.05).After acute exacerbation,right ventricular diameter 29.34±8.39mm?PAP 41.65±10.32 mm Hg,EF79.35±28.25%,right ventricular diameter25.65±5.28mm?PAP40.56±10.65 mm Hg,EF79.39±28.54% respectively were not significant(P> 0.05).After the treatment,the maximal oblique diameter of the right lobe in the acute attack group was 11.33±1.28 cm,the anteroposterior diameter of the right lobe was 8.38±1.54 cm,the length of the tail of the liver was 3.38±0.41 cm,and the largest oblique diameter of the right lobe in the stable group was 11.13±1.28 cm.The anteroposterior diameter of leaf was 8.62±1.39 cm and the length of caudal lobe was 3.63±0.33 cm(P> 0.05).4.The hematological indexes and cardiac ultrasonography were significantly correlated(P<0.05),while the hematological indexes had no significant correlation with hepatic ultrasonography(P> 0.05).Conclusion: 1.For cor pulmonale,the characteristics of BNP,PCT and CA125 increase in the clinical onset,especially in the acute stage,which is obviously higher than the stable period.Therefore,the hematological index BNP,PCT and CA125 can be used as the clinical diagnosis index of cor pulmonale.2.Coronary heart disease patients with color Doppler ultrasound parameters will have a greater change,but little change in liver color Doppler ultrasound.Therefore,cardiac ultrasound can be used as the main method of diagnosis of cor pulmonale.3.In the treatment of patients with cor pulmonale,the hematologic parameters and echocardiography can be significantly improved,and the stable period was not significantly different,indicating that the prognosis of patients with cor pulmonale can be analyzed by hematology and echocardiography.4.Hematology and echocardiography has a larger correlation,so the clinical indicators of patients with cardiac ultrasound can be inspected to guide the treatment. |
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