| Objective: To study the significance of plasma BNP level combined with related indicators in the evaluation of adverse conditions and clinical prognosis in elderly AECOPD patients during hospitalization.Methods: Clinical data were collected by retrospective method from September 2017 to September 2018 for elderly patients with acute exacerbation of COPD who were hospitalized in our respiratory department(181 cases met the inclusion criteria and exclusion criteria).The mean age(70.51±7.91 years).Using BNP value 100pg/m L as the dividing value,AECOPD patients were grouped with plasma BNP within 24 hours of admission: < 100pg/ml group I(153);? 100pg/ml group II(28).The general conditions(including past medical history,inflammatory index,blood gas index,blood gas index,lung function and cardiac ultrasound index,etc.)and hospitalization(including the number of hospitalizations within one year,hospitalization rate,respiratory use,transfer ICU,APACHEII score and CURB-65 score)were compared and analyzed.Using SPSS19.0 software analyses data to judge statistical significance.Result:(1)Compared to the age of the two groups,the level of BNP was higher among older persons with statistically significant differences(P<0.05).A further based on age 70,The plasma BNP values of ?70-year-old patients were much higher than those of 60-70-year-old group,and remained significantly different(P<0.05);(2)Comparison of general clinical indicators,plasma neutrophil ratio and PCT in II group are significantly higher than I groups,existence of statistical differences(P<0.05);Regarding the TNT level,the patients in II group were much larger than those in I group.The difference was significant(P<0.05).Blood gas analysis pH?PaO2?PaCO2 and other indicators were compared between the two groups.The PaO2 and PaCO2 values of II group were lower than that of I group,while the PH values of the group were higher than that of the group.Differences were statistically significant(all P<0.05).Among them,the BNP level of patients with hypoxemia and hypercapnia was significantly higher than that of patients without hypoxemia and hypercapnia.(3)Comparison of hospitalizations between two groups,the incidence of cor pulmonale was much higher in II group than in I group,The difference was significant(P<0.05).A comparison of the number of hospitalizations in one year and the rate of re-hospitalization found that,Patients in II group were significantly higher than those in I group and difference was significant(P<0.05).Moreover,when plasma BNP levels rise,APACHEII and CURB-65 scores increase.Differences were statistically significant(P<0.05).The ratio of patients with cor pulmonale in group I and group II,the number of hospitalizations due to acute exacerbation in 1 year,the rate of readmission in 1 year,the difference of Apache II score and CURB-65 score system were statistically significant(P<0.05).Moreover,the plasma BNP level of patients with cor pulmonale was significantly higher than that of patients without pulmonary heart disease.(4)Correlation analysis found that,Plasma BNP levels increased with age,increased TNT,increased inflammatory indicators(neutrophil ratio,PCT?CRP),increased PaCO2 levels,increased number of hospitalizations within one year,and increased APACHEII and CURB-65 scores.All presented positive correlations.However,when the pH,PaO2 and LVEF decreased,the level of BNP increased.All showed negative correlation.Conclusions: The plasma BNP level combined with the above clinical routine indicators is more conducive to further predict the progression of the elderly AECOPD patients and the risk of re-hospitalization,timely intervention to improve the clinical prognosis. |
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