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Objective:To explore the predictive factors of secondary pulmonary hypertension (PH) in patients with chronic obstructive pulmonary disease (COPD).Methods:The patients who were hospitalized and diagnosed with COPD in Huai′an Hospital Affiliated to Xuzhou Medical University from September 2017 to December 2019 were enrolled, and the pulmonary systolic pressure were estimated by echocardiography. The patients were divided into simple COPD group and COPD combined with PH group. The general clinical data, hematology indexes, and pulmonary function indexes of each group were collected and analyzed to explore the predictive value of the above factors on the occurrence of PH in COPD.Results:The levels of average blood platelet volume (MPV), red blood cell distribution width (RDW), and logarithmic functionof amino-terminal brain natriuretic precursor (lgNT-proBNP) in the in the COPD combined with PH group were higher than those in the simple COPD group: (11.91 ± 2.60) fl vs. (10.39 ± 1.44) fl, (14.25 ± 2.49)% vs. (12.56 ± 1.12)%, (2.82 ± 0.54) ng/L vs. (2.22 ± 0.38) ng/L; the ratio of forced expiratory volume in the first second (FEV 1) and force vital capacity (FVC) and the percentage of FEV 1 to the predicted value (FEV 1%) were lower than those in the simple COPD group: (51.43 ± 8.07)% vs. (59.99 ± 8.33)%, (37.00 ± 12.62)% vs. (48.28 ± 15.10)%, the differences were statistically significant ( P<0.05). Logistic regression analysis showed that the changes of MPV( OR = 1.401, P = 0.015), RDW ( OR = 1.769, P = 0.013), lgNT-proBNP ( OR = 6.959, P<0.001), FEV 1/FVC( OR = 0.905, P<0.001) were closely related to the occurrence of PH in COPD. The receiver operating characteristic (ROC) curve analysis showed that the area under the curve of MPV, RDW, NT-proBNP combined detection in diagnosis of PH was the largest (0.873). Conclusions:The changes in NT-proBNP, RDW, MPV, FEV 1/FVC have a certain predictive value for COPD patients with PH. The combined detection of three hematological indicators can better predict the presence of PH in COPD patients than single detection or combined detection.
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Eighty patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)complicated by pulmonary artery hypertention(PAH)were recruited in the study. All patients took conventional western medicine, among them 40 also received injection of Chinese herb medicine Shenxiong(study group)for 14 days. Mean pulmonary artery pressure(mPAP), plasma platelet alphagranule membrane protein(GMP-140), thromboxane B2(TXB2)and 6-keto-prostaglandin F1α(6-K-PGF1α)were measured before and after treatment in both groups. Compared with pretreatment levels and levels in control group mPAP, GMP-140 and TXB2 levels in study group were significantly decreased, while the levels of 6-K-PGF1α were significantly increased. The results indicate that Shenxiong injection may inhibit platelet activation and reduce mPAP.
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Chronic pulmonary obstructive disease is known to be a significant risk factor for mortality in patients who underwent operation for abdominal aortic aneurysm. To decrease perioperative respiratory complication in these patients, maintenance of self respiration as possible is one of the better method. A seventy-seven year old male patient complained of abdominal pain and he was diagnosed for 9 cm sized abdominal aortic aneurysm. But he had severe chronic obstructive pulmonary disease which was expected to increase surgical mortality. So we introduced epidural anesthesia with maintenance of self respiration and performed surgical resection and graft replacement of abdominal aorta, and he recovered without any complication.
Subject(s)
Humans , Male , Abdominal Pain , Anesthesia, Epidural , Aorta, Abdominal , Aortic Aneurysm, Abdominal , Lung Diseases, Obstructive , Mortality , Pulmonary Disease, Chronic Obstructive , Respiration , Risk Factors , TransplantsABSTRACT
Objective: To explore the function of serum leptin in COPD patients with malnutrition, and to investigate the relationship between leptin and TNF-?. Methods: A total of 81 subjects (47 COPD patients and 34 control subjects) participated in this study. The 47 COPD patients were divided into 2 groups: group COPD Ⅰ (patients without malnutrition during stable disease, n=29), group COPDⅡ(patients with malnutrition during stable disease, n=18).To eliminate the effect of sex differences, all the patients and controls were male. Body mass index (BMI), percent ideal body weight (IBW%), triceps skin-fold thickness (TSF), mid-upper arm circumference (MAC), mid-upper arm muscle circumference(MAMC),serum leptin and tumor necrosis factor-?(TNF-?) levels, serum prealbumin (PA), serum transferrin (TF), serum albumin(Alb),total lymphocytes count (TLC), forced expiratory volume in one second (FEV_1), maximal inspiration pressure(MIP)and maximal expiration pressure(MEP)were measured in all participants. Leptin levels were measured by radioimmunoassay. TNF-? levels were measured by ELISA. The between group difference and correlation of these parameters were analysed. Results: (1)Serum leptin levels were significantly lower in group COPDⅡ (4.07?3.42 ?g/L) than in group COPD Ⅰ(9.72?6.67 ?g/L)and controls(8.21?5.41 ?g/L, P
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Objective To observe the alteration of bone metabolism and to study the pathogenesis of osteoporosis and factors in elderly patients with chronic obstructive pulmonary diseases (COPD). Methods The biochemical markers of bone metabolism, bone mineral density (BMD) of the lumbar spine and the right femur, parameters of calcaneal quantitative ultrasound(QUS), blood partial pressure and pulmonary functions in 39 male patients with COPD and 30 controls were measured. Results The broadband ultrasonic attenuation (BUA) and the speed of sound (SOS), BMD of the lumbar spines and the femur were significantly lower than that in control group. The biochemical markers of bone metabolism such as HOP/Cr, Ca/Cr, and PTH in the COPD group was significantly raised than that in control group〔(60 2?7 0)dB/MHz vs (66 5?4 9)dB/Mhz,(1 328 4?41 5)m/s vs (1 505 8?26 9)m/s,23% vs 34%,21% vs25%〕. The serum levels of Testosterone(T) reduced significantly ( P
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AIM: To establish rat chronic obstructive pulmonary disease(COPD) models by passive cigarette smoking plus intratracheal instillation of lipopolysacchride(LPS) or passive cigarette smoking only, which would be similar to the pathogenesis of human COPD. METHODS: 48 Wistar rats were randomly divided into 4 groups.(1) Healthy control I group( n =12), rats were bred 4 weeks;healthy control II group( n =12), rats were bred for 3 months. (2) Model group I ( n =12), 200 ?g lipopolysaccharide(LPS) was instilled intratracheally once for every two weeks and the rats were exposured to 5% of cigarette smoke, 0.5 h/d for 4 weeks.(3) Model group II(n=12),rats were exposed to 5% of cigarette smoke, 0.5 h/d for 3 months. The pathologic changes of airways and lung tissues, pulmonary function and blood gas analysis were determined. The airway wall lymphocytes and alveolar macrophages were counted. The cross areas of epithelial layer, smooth muscle layer and lamina propria of bronchi were measured. The hydroxyproline of lung tissue homogenates was determined by biochemistry method. RESULTS: The pathologic changes of airways and lung tissue of two models were similar to but milder than those of COPD patients(biopsy data). The collagen deposition and the cross areas of epithelial layer and smooth muscle layer in airway walls of two model groups were significantly increased than those of control groups( P
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Objective To compare the efficacy of postoperative noninvasive positive pressure ventilation ( NPPV ) plus standard medical therapy ( SMT) with SMT alone in patients with moderate to severe chronic obstructive pulmonary disease ( COPD )Methods Twenty-four patients, after upper abdominal or thoracic surgery, who suffered from COPD and moderate to severe respiratory insufficiency, were randomly allocated to receiving SMT alone (oxygen, aminophylline infusion, nebulized beta-2 agonists and anticholinergics, antibiotics administration and chest physiotherapy; control group ,n=12) or NPPV in addition to SMT(NPPV group ,n=12) NPPV was intermittently given with an air-cushioned face mask under the continuous positive airway pressure of 3 cmH 2O and FiO2 of 35%Results There were not significant differences in baselines between both groups 8 patients in control group ( 667%) and all patients in NPPV group recovered with initial therapy with statistically significant difference (P