The Significance Of Myocardial Injury Markers In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease Of Old Patients

ObjectiveTo explore the clinical significance of myocardial injury markers in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) of old patients and level of myocardial injury markers with hypoxemia, and to explore the relationship between myocardial injury markers level and clinical prognosis.Methods1. To check arterial blood gas and myocardial injury markers of 39 cases with AECOPD treated in our department during Mar 2013 to Oct 2014 and 39 healthy cases as well. Giving AECOPD patients with actively oxygen therapy, spasmolysis, anti-asthmatic treatment, when necessary with anti-infection and noninvasive ventilator assisted ventilation treatment. After treatment the survival and released 33 patients were divided into the survival group. Compared differences of myocardial injury markers among acute exacerbation released and health group.2. The AECOPD patients were divided into three degrees of mild moderate and severe hypoxia by PaO2 level and to explore the differences myocardial injury markers.3. To analyze relevance between PaO2 level and myocardial injury makers.4. AECOPD patients with no alleviation and transferred to death were divided into the death group, others were included in the survival group, Compared the differences of the myocardial injury markers between the death and survival group.Results1. Compared Cardiac troponin I (cTNI)、Creatine kinase isoenzyme (CK-MB) and myoglobin (MYO) in acute exacerbation group, released group and health group, the level of myocardial injury markers in AECOPD patients is obviously higher than the other two groups,there are great significant differences of myocardial injury markers between AECOPD group, survival and healthy group (P<0.001),but there was no great diference between the released group and the health group(P>0.05).2. There was great differences due to the level of myocardial injury markers including CK-MB cTNT-I and MYO in severe hypoxia is much higher than mild and moderate group(P<0.001), but there was no significant difference between the moderate and mild hypoxemia groups (P >0.05).3.There was a linear negative correlation between PaO2 and cTNI (r=-0.481, P<0.05), but no linear correlation with CK-MB and MYO (P>0.05).4. There were great differences between death group and survival group in AECOPD patients(P<0.05)Conclusion:In old AECOPD patients the level of myocardial injury markers can significantly increase associated with hypoxemia, and the PaO2 level has a linear negative correlation with cTNI, the more severe hypoxia, the higher myocardial injury markers increased significantly, the high mortality. So there are great guiding significances to evaluate the old AECOPD patients to check the myocardial injury markers level,especially to the degree of myocardial injury, judgement of prognosis to improve the curative effect with important guiding significance.