Correlation study of serum NT-Pro BNP, CRP and D-Dimer levels in patients of AECOPD with pulmonary hypertension

Abstract

Objective To explore the clinical significance and correlation of serum amino terminal pro brain natriuretic peptide (NT Pro BNP),C-reaction protein (CRP) and the D-Dimer levels in patients of the acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with pulmonary hypertension(PH).Methods One hundred and twenty six patients with AECOPD were measured pulmonary artery systolic pressure (PASP) by echocardiography.They were divided into 3 groups according to PASP:control group (＜40 mmHg) 45 cases,mild PH group (40～60 mmHg) 47 cases and mederate-severe PH group (＞60 mmHg) 34 cases.Serum NT Pro BNP,CRP,D-Dimer levels and arterial blood gas analysis were detected from all the selected patients.Results Serum NT Pro BNP,PCO2,CRP and D-Dimer in AECOPD with mederate-severe PH group [NT-Pro BNP:(1 711.15 ± 437.05) ng/L;PCO2:(47.24±8.60) mmHg;CRP:(25.53±1.73) mg/L;D-Dimer:(648.88±618.37) μg/L]were significantly higher than the control ones [NT-Pro BNP:(221.78±63.62) ng/L;PCO2:(40.04±6.83) mmHg;CRP:(11.51±2.00) mg/L;D-Dimer:(302.58±233.44) μg/L](t =-4.005,-3.880,-3.094,-4.073; P ＜0.05) ;while PO2 [arterial partial pressure of oxygen:(59.43 ± 16.49) mmHg]were significantly lower than the control ones (71.28±15.16) mmHg (t =3.276; P ＜0.05).Serum NT-Pro BNP,PCO2 in AECOPD with mederate-severe PH group [NTPro BNP:(1 711.15 ±437.05) ng/L; PCO2:(47.24 ± 8.60) mmHg] ; were significantly higher than the mild PH ones [NT Pro BNP:(583.77±213.98) ng/L;PCO2:(40.85±8.96) mmHg](t =-3.069,-3.442; P ＜0.05) ;while PO2 (59.43 ± 16.49)] mmHg were significantly lower than the mild PH group ones (66.81 ±16.22) mmHg (t =2.061; P ＜0.05).Serum CRP and the D-Dimer levels in mild PH group [CRP:(17.55 ±4.17) mg/L;D-Dimer:(501.61±218.71) μg/L] were significantly higher than the control ones [CRP:(11.51±2.00) mg/L;D-Dimer:(302.58±233.44) μg/L](t =-1.452,-2.551; P ＜ 0.05).NT-Pro BNP was observered a significant positive linear relationship between PASP (r =0.346,t =4.11,P ＜0.01) and PCO2(r =0.336,t =3.97,P ＜0.01)).We also found that PCO2,CRP,D-Dimer levels have a significant positive linear relationship between PASP(r =0.389,t =4.70; r 0.245,t =2.81; r =0.349,t=4.15; P＜0.05),whilePO2 was negatively correlated withPASP (r=-0.262,t=3.02,P ＜ 0.05).Conclusions Serum NT-Pro BNP,CRP and D-Dimer levels are closely related to the PASP,and can be used as indicators to judge the severity of PH in of AECOPD patients. Key words: Chronic obstructive pulmonary disease; Pulmonary hypertension; N-terminal pro-brain natriuretic peptide ; C-reaction protein ; D-Dimer