Research On The Expression Level Of Serum GDF-15 And SST2,and Their Correlation With Prognosis In AECOPD Patients With Pulmonary Hypertension

Objective:Detect the expression level of serum growth differentiation factor-15(GDF-15),soluble suppression of tumorigenicity 2(sST2)in patients with acute exacerbation of chronic obstructive pulmonary disease complicated with pulmonary hypertension(AECOPD-PH),and further analyze the relationship between the level of serum GDF-15,sST2 and hospitalization days,as well as prognosis.Methods:There were 126 patients with acute exacerbation of chronic obstructive pulmonary disease who were in hospitalization in respiratory and critical care department of the Third Clinical Medical College of Shanxi Medical University from July 2020 to October 2021,recording the general clinical baseline data,hospitalization days and transthoracic echocardiography(TTE)indicator,etc.,and detecting serum GDF-15,sST2 level at the time of admission.According to the TTE,the low,medium,high possibility of PH is evaluated,and high likelihood PH is divided into AECOPD-PH group(57cases),the rest is included in simple AECOPD group(69 cases).The serum GDF-15,sST2 level was compared at the two groups.Draw the ROC curve,and calculate the area under curve(AUC)to test the value of the serum GDF-15,sST2 level in calculate the underlying area(AUC)to test the level to predict the risk of PH in AECOPD patients.Correlation analysis was conducted between hospitalization days and serum GDF-15,sST2 level in 57 patients in AECOPD-PH group who have a 90 days follow-up further,dividing them into poor prognosis(36 cases)and control group(21 cases)depending on whether hospitalized again due to AECOPD in 90 days,comparing serum GDF-15 and sST2 level in two groups.The best threshold for serum GDF-15 and sST2 in AECOPD-PH patients with poor prognosis risk were identified using ROC curve analysis.Results:Serum GDF-15,sST2 levels were significantly increased in the AECOPD-PH group,and the ROC curve analysis showed serum GDF-15,sST2 levels were given a certain value for the combined PH of AECOPD patients.In AECOPD-PH group,there is no significant correlation between hospitalization days and serum GDF-15,sST2 levels,P> 0.05.The poor prognosis group have higher serum GDF-15 and sST2 level,prompting risk of poor prognosis.The AUC of serum GDF-15,sST2 and combined testing to identify poor prognosis risk in AECOPD-PH patients is 0.946,0.701,0.950,respectively.The best threshold of serum GDF-15,sST2 identifying poor prognosis risk in AECOPD-PH patients is 1309.72 pg / ml and 59.10 ng / ml.Conclusion:Serum GDF-15,sST2 may be used as predictor of PH in AECOPD patients.Serum GDF-15,sST2 is potential indicator for assessing poor prognosis of AECOPD-PH patients.