Analysis of predictive factors for pulmonary hypertension in patients with chronic obstructive pulmonary disease / 中国医师进修杂志

ABSTRACT

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.