Clinical Significance Of BODE Index,BNP,hs-CRP In Patients With Chronic Obstructive Pulmonary Disease Complicated By Pulmonary Hypertension

Objective:To investigate the BODE index,brain natriuretic peptide(BNP)and hypersensitive C-reactive protein(hs-CRP)in chronic obstructive pulmonary disease(COPD)complicated by pulmonary hypertension(PH)significance of clinic in patients.Method:COPD patients were continuously collected from December 2018 to December 2019 according to the COPD diagnostic criteria,and 94 cases of COPD patients met the inclusion criteria.Pulmonary systolic blood pressure(PASP)was measured according to the 2009 European Society of Cardiology(ESC)guidelines,and patients were divided into three groups: the simple COPD group(PASP<36 mm Hg),and the COPD with mild PH group(PASP: 36-50 mm Hg)and COPD with moderate to severe PH group(PASP>50mm Hg).Measure the levels of PASP,plasma BNP,and serum hs-CRP in all subjects,and the forced expiratory volume in the first second as a percentage of the expected value(FEV1% pred),a modified British Medical Research Council breathing questionnaire(m MRC),and a six-minute walk The distance(6MWD)and the level of body mass index(BMI)were used to calculate the BODE index score Results:1.There were no significant differences in age,gender,smoking index,BMI,and creatinine(Cr)between the groups(P>0.05).2.The differences in BODE index,plasma BNP level,serum hs-CRP level,m MRC score,6MWD,and FEV1% pred of the three groups were statistically significant(P<0.05);further pairwise comparison,BODE index,BNP,hs-CRP The COPD with moderate to severe PH group was higher than the COPD with mild PH group,the COPD with moderate to severe PH group was higher than the simple COPD group,and the COPD with mild PH group was higher than the simple COPD group.The differences between the groups were statistically significant(P<0.05),6MWD in COPD with moderate-severe PH group is lower than COPD with mild PH group,COPD with moderate-severe PH group is lower than COPD-only group,COPD with mild PH group is lower than COPD-only group,there are differences between groups Statistical significance(P<0.05).FEV1% pred was statistically significant in COPD with moderate-severe PH group and COPD with mild PH group,COPD with moderate-severe PH group and COPD group alone(P<0.05).There was no significant difference between the mild PH group and the simple COPD group(P>0.05).3.Correlation analysis of PASP showed positive correlation with BODE index level,plasma BNP level,serum hs-CRP level,and m MRC level,and negative correlation with 6MWD.The rvalues were 0.786,0.669,0.794,0.717,-0.679.,P <0.05.There was no correlation between FEV1% pred level and BMI level with PASP(P>0.05).Five factors(BODE index,BNP,hs-CRP,m MRC value,6MWD)were selected into the regression equation using PASP as the dependent variable and related indicators as the independent variables.Conclusion:1.The BODE index and m MRC value of patients with COPD and PH are higher than those of patients with pure COPD.The 6MWD of patients with COPD and PH are lower than those of patients with pure COPD.There is a positive correlation between PASP,BODE index,and m MRC,and a negative correlation with 6MWD It is suggested that the BODE index can be used as a more comprehensive indicator to monitor COPD accompanied by PH,and the m MRC value and 6MWD can also be used as daily monitoring indicators of COPD accompanied PH.2.Patients with COPD and PH have higher levels of BNP and hs-CRP than patients with COPD alone,and there is a positive correlation between PASP and hs-CRP and BNP,suggesting that systemic inflammation and vasoactive peptides are involved in COPD with PH.Disease process.