| Objective:This study is to investigate the expression of diameter ratio of main pulmonary aorta to descending aorta measured by CT(r PDA),N-terminal brain natriuretic peptide precursor(NT-pro BNP)and D-dimer in AECOPD(Acute exacerbation of chronic obstructive pulmonary disease,AECOPD)patients complicated with PH(Pulmonary hypertension,PH),and to summarize their correlations.Then the clinical diagnostic value of r PDA,NT-pro BNP and D-dimer in AECOPD patients complicated with PH can be determined.Methods:79 AECOPD patients complicated with PH were collected as AECOPD combined with PH group,45 AECOPD patients without PH were collected as AECOPD alone group,45 healthy subjects were treated as normal control group during the same period.Plasma NT-Pro BNP and D-dimer were measured within 24 hours after admission.Chest spiral CT scan,pulmonary ventilation function and echocardiography were also performed in all subjects in the same period.The diameter of main pulmonary artery and descending aorta were measured at the CT mediastinal window by spiral CT.The diameter ratio of main pulmonary artery to descending aorta was obtained by dividing the diameter of main pulmonary artery by diameter of descending aorta.Pulmonary artery pressure(PASP)was measured by Color Doppler ultrasonography.The pulmonary ventilatory function of the patients was measured by pulmonary function instrument,and then the diagnosis of COPD was confirmed.The levels of NT-pro BNP in patients were measured by fluorescence immunochromatography and the levels of D-dimer were measured by Latex immunoturbidimetry.The correlation between r PDA,NT-pro BNP,D-dimer and PASP was analyzed by statistical software.Results:1.The serum NT-pro BNP in AECOPD combined with PH group was significantly higher than that in AECOPD group and control group(p < 0 05).The serum NT-pro BNP in AECOPD group was higher than that in control group and there was significant difference between AECOPD group and control group(p < 0.05).2.r PDA in AECOPD combined with PH group was significantly higher than that in AECOPD alone group and control group(p < 0 05).r PDA in AECOPD alone group was higher than that in control group,but there was no significant difference between AECOPD group and control group.3.The D-dimer in AECOPD with PH group and AECOPD group were both significantly higher than that in control group(p < 0.05)and there was statistical significance.The D-dimer in AECOPD with PH group was higher than that in AECOPD group(p <0.05),but there was no statistical significance.4.The correlation analysis showed that there was a significant positive correlation between r PDA,serum NT-pro BNP and PASP(r=0.548、0.602,p < 0.05),There was a positive correlation between D-dimer and PASP,but the correlation was weak(r = 0.155,p =0.045).Conclusion:1.NT-pro BNP in patients with AECOPD is higher than that in healthy subjects,indicating that AECOPD could lead to an increase in NT-pro BNP levels.2.NT-pro BNP levels in patients with AECOPD and PH are significantly higher than those in healthy people and patients with AECOPD alone,indicating that when AECOPD develops to PH,The level of NT-pro BNP increases sharply.3.The level of NT-pro BNP is closely related to the degree of pulmonary hypertension.This is of great significance in differentiating whether AECOPD patients are complicated by pulmonary hypertension or not,and then has important clinical signifi-cance in evaluating the condition of the patients.4.r PDA can be used in the diagnosis of COPD-associated PH by CT.It is a simple and effective method to evaluate PH.5.Blood hypercoagulability exists in patients with AECOPD.There is a weak correlation between D-dimer and PASP,which can reflect the level of PH to a certain extent. |
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