Analysis Of Clinical Risk Factors Of COPD With Pulmonary Hypertension

ObjectiveTo observe the blood parameters changes in patients with chronic obstructive pulmonary disease complicated with pulmonary hypertension,as well as analyze the correlation between the pulmonic pressure and the blood indexes,which includes brain natriuretic peptide(BNP),D-dimer(D-D),high sensitivity C reactive protein(hs-CRP),hematocrit(HCT),mean platelet volume(MPV),prealbumin(PA),uric acid(UA).With the aim to further clarify the clinical significance of these indexes in COPD patients accompanied pulmonary hypertension.MethodsWe collect 153 COPD patients diagnosed in the respiratory medicine of Affiliated Hospital of Tai’an Medical College from January 1,2016 to January 1,2017.These patients were divided into 4 groups,according to the values of pulmonary artery systolic pressure measured by echocardiography.Group A: the normal pulmonary artery pressure group(PASP<35mmHg),75 cases.Group B: the mild pulmonary hypertension group(35mmHg≤PASP<50mmHg),30 cases.Group C: the moderate pulmonary hypertension group(50mmHg≤PASP<70mmHg),27 cases.Group D: the severe pulmonary hypertension group(PASP ≥70mmHg),21 cases.The BNP,D-D,hs-CRP,HCT,MPV,PA,UA were compared between groups,and the correlation between these indexes and pulmonary arterial systolic blood pressure was investigated.Results1.BNP,D-D,hs-CRP,HCT,MPV and PA differences were significantly satistically by comparing the pulmonary hypertension group and control group(P<0.01).2.BNP: BNP differences were statistically significant by comparing the moderate PH group and the normal PH group,the severe PH group and the normal PH group(P<0.05).The difference was statistically significant between the severe PH group and the mild PH group(P<0.05),while there was no statistically significant between the mild PH group and the normal PH group(P>0.05).There was a positive correlation between pulmonary artery pressure and BNP,and the correlation coefficient was r=0.461(P<0.01).3.D-dimer: D-dimer differences were statistically significant by comparing the mild PH group and the normal group,the moderate PH group and the normal PH group,the severe PH group and the normal group(P<0.05).The difference was statistically significant between the severe PH group and the mild PH group(P<0.05).There was a positive correlation between pulmonary artery pressure and D-D,and the correlation coefficient was r=0.492(P<0.01).4.hs-CRP: hs-CRP differences were statistically significant by comparing the moderate PH group and normal group,the severe PH group and the normal PH group(P<0.05).The differences were statistically significant by comparing the severe PH group and the mild PH group,the severe PH group and the moderate PH group(P<0.05).There was a positive correlation between pulmonary artery pressure and hs-CRP,with a correlation coefficient of r=0.385(P<0.01).5.HCT: HCT differences were statistically significant by comparing the mild PH group and the normal group,the moderate PH group and the normal group,the severe PH group and the normal group(P<0.05).The differences were statistically significant by comparing the moderate PH group and the mild PH group,the severe PH group and the mild PH group(P<0.05).The difference was statistically significant between the severe PH group and the moderate PH group(P<0.05).There was a positive correlation between pulmonary artery pressure and HCT,with a correlation coefficient of r=0.687(P<0.01).6.MPV: MPV differences were statistically significant by comparing the mild PH group and the normal group,the moderate PH group and the normal group,the severe PH group and the normal PH group(P<0.05).The differences were statistically significant by comparing the moderate PH group and the mild PH group,the severe PH group and the moderate PH group(P<0.05).There was a positive correlation between pulmonary artery pressure and MPV,and the correlation coefficient was r=0.610(P<0.01).7.PA: PA differences were statistically significant by comparing the mild PH group and the normal group,the moderate PH group and the normal group,the severe PH group and the normal PH group(P<0.05).There was a negative correlation between pulmonary artery pressure and PA,and the correlation coefficient was r=-0.314(P<0.01).8.UA: Each group was compared UA and contrasted with each other,UA differences were not statistically significant(P>0.05).There was no correlation between pulmonary arterial pressure and UA.Conclusions1.In COPD patients complicated with pulmonary hypertension,whose levels of BNP,D-D,hs-CRP,HCT,MPV were higher than those in normal group.While the expression of PA in COPD patients complicated with pulmonary arterial hypertension was lower than that in normal pulmonary artery pressure group.BNP,D-D,hs-CRP,HCT,MPV,PA could be used as the clinical indicators to evaluate the condition of COPD complicated with pulmonary hypertension.2.The levels of pulmonary arterial pressure was positively correlated with BNP,D-D,hs-CRP,HCT and MPV,while pulmonary arterial pressure was negatively correlated with PA.BNP,D-D,hs-CRP,HCT,MPV and PA can be used as reference indicators for evaluating the severity of pulmonary hypertension.3.There were no statistically significant differences in the UA between the pulmonary hypertension group and the normal pulmonary artery pressure group.There was no correlation between pulmonary arterial pressure and UA.