The Clinical Significance Of FEV1 And Serum BNP Levels In Acute Chronic Obstructive Pulmonary Disease With Heart Failure

Objective:To discuss the clinical severity scales of acute exacerbation of chronic obstructive pulmonary disease(COPD)and AECOPD with heart failure(HF),forced expiration volume in first second(FEV1)and serum B-type brain natriuretic peptide(BNP)were measured.For provide a theoretical basis to early diagnosis and treatment of AECOPD with HF and assess the disease severity and prognosis.Methods:143 patients with AECOPD and 81 patients who were diagnosed AECOPD with HF were recruited,who were inpatient in the first hospital of Jilin universi from May2015 to May 2016.The medical history,age,sex,height,weigh,smoke were collected through questionnaires.The lung function and serum BNP level were detected in all individuals.The patients in AECOPD with HF group underwent arterial blood gas test and echocardiography on the basis of general condition.1.According to the results of spirometry and chronic obstructive pulmonary disease guideline(2013 revision),the AECOPD group can be divided into class II(moderate)19 cases,class III(severe)79cases,class IV(extremely severe)45 cases,comparing the levels of FEV1 and serum BNP in each class.2.On the basis of NYHA grading standard,24,36,31 individuals were divided into level II,III,IV,separately.Comparing the FEV1 and blood BNP levelsamong groups.3.Make a comparison between simple AECOPD group and AECOPD with HF,observe whether there were correlation in FEV1 and serum BNP levels.Results:1.There were no statistically difference in age,sex,BMI,smoking history between AECOPD alone group and AECOPD combine with HF(P>0.05).2.The levels of FEV1 were 1.46±0.62 L,0.93±0.24 L,0.65±0.16 L,the content of serum BNP were 47.34±24.37pg/ml,97.41±55.67pg/ml,200.44±56.02pg/ml in moderate,severe,extremely severe AECOPD patients,respectively.Adopt completely random design of single factor analysis of variance,the difference was statistically significant with pairwise comparison(F=77.145,P=0.000).3.The levels of FEV1 and BNP of NYHAII?III?IV class in AECOPD with HF were 0.91±0.37 L ? 267.89±415.09pg/ml,0.62±0.22 L ? 2942.21±3116.45pg/ml,0.41±0.13 L,10688.38±10274.44pg/ml,the differences were all statistically significant(P<0.05).4.The standards of FEV1 were 0.91±0.39 L,0.65±0.32 L and BNP levels were123.18±76.03pg/ml,3622.53±4749.55pg/ml in AECOPD group and AECOPD with HF group,separately,there were statistically significant difference(P<0.05).5.The FEV1 was negatively correlated with serum BNP in AECOPD and AECOPD with HF group(r=-0.723,-0.427),the difference were statistically significant(P<0.01).Conclusion:1.Serum BNP levels were negatively correlated with FEV1,who can be used asan indicator to evaluate the disease severity.2.Elevated serum BNP is prevalent in patients with simple AECOPD,which was positively correlated with the severity of disease,therefore,it can be used as an index to evaluate the severity of disease.