| Objective:To explore the correlation between red cell distribution width(RDW),platelet lymphocyte ratio(PLR),mean platelet volume(MPV)and severity of disease in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with pulmonary hypertension and provide a basis for clinical evaluation of patients' condition.Methods:(1)A retrospective study was conducted 196 AECOPD patients who were in the respiratory department of people's hospital of xiangxi autonomous prefecture from Noverber 2015 to July 2020.According to measurement of pulmonary artery systolic pressure,they selected 103 AECOPD patiens with normal PASP and 93 AECOPD patients complicated with pulmonary hypertension.At the same time,77 cases of healthy examination people were collected as the normal control group.The patients with AECOPD complicated with pulmonary hypertension weredivided into groups according to PASP?36mm Hg:the mild PH(36mm Hg?PASP?50),the moderate PH(50mm Hg <PASP?70mm Hg),and the severe PH(PASP>70mm Hg).(2)To summarize each general information,echocardiography indexes:left atrium diameter(LAD),left ventricular end diastolic diameter,(LVD),right ventricular diameter(RVD),left ventricular ejection fraction(LVEF),main pulmonary artery diameter(DPA),and collect the mean platelet volume(MPV),red blood cell distribution width(RDW)and white blood cell(WBC),platelet count(PLT),lymphocyte(LY),platelet distribution width(PDW),serum creatinine(Cr),hemoglobin(HB),neutrophils(NEU),and calculate the platelet/lymphocyte ratio(PLR).(3)The differences of general condition,echocardiographic index and blood index in each group were statistically analyzed.the risk factors of AECOPD complicated with pulmonary hypertension were analyzed by multivariate Logistic regression.Receiver operating characteristic curve(ROC)was drawed on predicting the diagnostic value of related blood indexes in AECOPD complicated with pulmonary hypertension,and the correlation between each index and PASP was analyzed by Spearman correlation.(1)There were significant differences in RDW,MPV and PLR among the three groups.Pairwise comparison showed that RDW,PLR and MPV in pulmonary hypertension group and AECOPD group were significantly higher than those in normal control group,and RDW,PLR and MPV in pulmonary hypertension group were significantly higher than those in AECOPD group.(2)PLR,MPV and RDW in severe pulmonary hypertension group were significantly higher than those in mild pulmonary hypertension group,RDW in moderate pulmonary hypertension group was significantly higher than that in mild pulmonary hypertension group,and PLR in severe pulmonary hypertension group was significantly higher than that in moderate pulmonary hypertension group.(3)Multivariate Logistic regression analysis showed that smoking,sex,RDW and RVD were the risk factors of AECOPD complicated with pulmonary hypertension,while PLR,MPV and age were not risk factors.(4)Diagnostic value: The areas under ROC curve of RDW,PLR and MPV in patients with AECOPD complicated with pulmonary hypertension were 0.743,0.657 and 0.615,respectively.In order to further improve the diagnostic value of the three indexes in the diagnosis of AECOPD complicated with pulmonary hypertension,the areas under ROC curve of RDW+MPV,RDW+PLR,MPV+PLR and RDW+MPV+PLR were 0.774,0.757,0.676 and 0.779 respectively.Results:(5)In the pulmonary hypertension group,the correlation analysis between RDW,PLR,MPV and PASP showed that RDW,PLR,MPV and PASP were positively correlated,and the correlation coefficients were0.328,0.338 and 0.218,respectively.Conclusions:(1)The increased levels of RDW,PLR and MPV have certain value in the diagnosis of AECOPD complicated with pulmonary hypertension.(2)RDW is a risk factor for pulmonary hypertension in AECOPD,while PLR and MPV are not risk factor.(3)The combination of elevated RDW,PLR and MPV can better predict the existence of pulmonary hypertension.(4)RDW,PLR and MPV are positively correlated with the severity of PASP,which can be used as an index to evaluate the condition of patients with AECOPD complicated with pulmonary hypertension. |
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