Analysis Of Relevant Factors Of AECOPD Combined With Pulmonary Hypertension

Objective:By analyzing the commonly used serological indexes（such as blood routine,liver and kidney function,etc.）,the relevant factors of AECOPD combined with pulmonary hypertension were detected at an early stage,and the correlation between these indexes and the level of PASP was further studied to provide a basis for clinical preliminary screening of AECOPD combined with pulmonary hypertension and judging the severity.Methods:The medical record data of patients who were hospitalized in the Department of Respiratory Medicine of the Affiliated Hospital of Yan’an University and diagnosed with AECOPD from January 2020 to December 2022 were collected,and a total of 200 cases met the nadir criteria.Grouping:The included patients were divided into 100 cases in the AECOPD-non-PH group（PASP≤30 mm Hg）and 100 cases in the AECOPD-PH group（PASP>30 mm Hg）based on the measured pulmonary artery systolic pressure level,and the AECOPD-PH group was further divided into 55 patients in the mild AECOPD-PH group（PASP 31-50 mm Hg）and 45 patients in the moderate to severe AECOPD-PH group（PASP>50 mm Hg）.General data（age,gender,BMI,duration of illness,number of days in hospital,smoking status）and clinical data（arterial blood gas analysis indexes,blood routine indexes,liver and kidney function indexes,blood coagulation indexes and PASP）were collected from the patients.Using SPSS 26.0software analyzed the above general and clinical data,the related factors associated with AECOPD-PH were analysed by using Logistic regression and Spearman’s rank correlation was applied to analyse the correlation between serological indicators and PASP.Result:1.Comparison of general information between AECOPD-non-PH and AECOPD-PH groups.Among 200 patients with AECOPD,the AECOPD-PH group had a greater age,number of days in hospital,and proportion of women than the AECOPD-non-PH group（P<0.05）,a smaller BMI than the AECOPD-non-PH group（P<0.05）,and no statistical significance in terms of duration of disease and smoking history（P>0.05）.2.Comparison of clinical data between AECOPD-non-PH and AECOPD-PH groups.Among 200 patients with AECOPD,in terms of arterial blood gas indexes,PaCO₂ in the AECOPD-PH group was greater than that in the AECOPD-non-PH group（P<0.05）,Pa O₂ and Sa O₂ were less than that in the AECOPD-non-PH group（P<0.05）,and the two groups had no statistically significant differences in p H,HCO₃^-were not statistically significant（P>0.05）.In terms of routine blood indices,RDW and MPV in the AECOPD-PH group were greater than those in the AECOPD-non-PH group（P<0.05）,RBC and Hb were smaller than those in the AECOPD-non-PH group（P<0.05）,and between the two groups,WBC,NEU,and PLT were not statistically significant（P>0.05）.In terms of liver and kidney function indexes,UA and Cys-C were greater in the AECOPD-PH group than in the AECOPD-non-PH group（P<0.05）,TP,ALB,ALT,and CR were smaller than in the AECOPD-non-PH group（P<0.05）,and there was no statistical significance between the two groups in AST,GGT,TBi L,DBi L,IBi L,UN,and NO（P>0.05）.In terms of blood coagulation indexes,PT,FIB,and D-D were greater in the AECOPD-PH group than in the AECOPD-non-PH group（P<0.05）,and there was no statistical significance in APTT in the two groups（P>0.05）.3.The statistically significant indicators in univariate analysis（age,gender,BMI,hospitalization days,PaCO₂,Pa O₂,Sa O₂,RBC,Hb,RDW,MPV,TP,ALB,ALT,CR,UA,Cys-C,PT,FIB,D-D）were selected for binary Logistic regression model analysis,and the results suggested that PaCO₂（OR:1.090,95%CI:1.008-1.177）,RDW（OR:1.460,95%CI:1.047-2.034）,MPV（OR:1.886,95%CI:1.230-2.893）,and UA（OR:1.008,95%CI:1.001-1.014）were statistically significant（P<0.05）,which were related factors of AECOPD complicated with PH.4.Comparison of general information of AECOPD-PH patients in two groups.Among 100 patients with AECOPD-PH,there was no statistically significant difference between the mild AECOPD-PH group and the moderate to severe AECOPD-PH group in terms of age,gender,BMI,duration of disease,days of hospitalization,and smoking history（P>0.05）.5.Comparison of clinical data between two groups of patients with AECOPD-PH.Among 100 patients with AECOPD-PH,in terms of routine blood indices,RDW and MPV in the moderate-severe AECOPD-PH group were greater than those in the mild AECOPD-PH group（P<0.05）,and there was no statistical significance between the two groups in terms of WBC,NEU,RBC,Hb,and PLT（P>0.05）.In terms of liver and kidney function indexes,TP,UA,and Cys-C in the moderate-severe AECOPD-PH group were greater than those in the mild AECOPD-PH group（P<0.05）,and there was no statistical significance between the two groups in terms of ALB,ALT,AST,GGT,TBi L,DBi L,IBi L,UN,CR,and NO（P>0.05）.In terms of blood coagulation indexes,FIB and D-D were greater in the moderate-severe AECOPD-PH group than in the mild AECOPD-PH group（P<0.05）,and there was no statistical significance in PT and APTT in both groups（P>0.05）.6.The correlation analysis between the statistically significant indicators in 100AECOPD-PH groups and PASP levels showed that:RDW,MPV,UA,Cys-C,FIB,D-D and PASP were positively correlated（coefficients of correlation were 0.376,0.419,0.298,0.390,0.326 and 0.333,respectively,P<0.05）,while TP was not correlated with PASP（P>0.05）.Conclusions:1.PaCO₂,RDW,MPV and UA are independent related factors for AECOPD with PH.Clinically,if the levels of PaCO₂,RDW,MPV and UA are abnormally increased in AECOPD patients,we are supposed to be alert to the possibility of complication with PH.2.RDW,MPV,UA,Cys-C,FIB and D-D were positively correlated with PASP,suggesting that RDW,MPV,UA,Cys-C,FIB and D-D can help us assess the severity of disease in patients with AECOPD-PH and guide treatment.