Abstract:
Objective To explore changes and significance of serum high sensitivity C reactive protein(hs-CRP), N-terminal pro-brain natiuretic peptide(NT-proBNP)and glomerular filtration rate(GFR)in patients with chronic obstructive pulmonary disease(COPD)complicated with heart failure.
Methods A retrospective analysis was performed on clinical records of 94 COPD patients. According to presence or absence of heart failure, they were divided into COPD combined with heart failure group(
n=69)and simple COPD group(
n=25). In the same period, 100 healthy people underwent physical examination were enrolled as normal control group. The changes in serum hs-CRP, NT-proBNP and GFR in patients with COPD and heart failure were observed.
Results The levels of total cholesterol(TC), triglyceride(TG)and low-density lipoprotein cholesterol(LDL-C)in COPD combined with heart failure group were significantly higher than those in simple COPD group and - normal control group(
P<0.05), while level of high-density lipoprotein cholesterol(HDL-C)was significantly lower than that in simple COPD group and normal control group(
P<0.05). The levels of interleukin-1β(IL-1β), hs-CRP, tumor necrosis factor-α(TNF-α), NT-proBNP and serum creatinine(Scr)in COPD combined with heart failure group were significantly higher than those in simple COPD group and normal control group(
P<0.05), while GFR level was significantly lower than that in simple COPD group and normal control group(
P<0.05). Logistic regression analysis showed hs-CRP(
OR=1.826,
P=0.037), NT-proBNP(
OR=1.848,
P=0.021)and GFR(
OR=1.779,
P=0.024)were influencing factors for COPD combined with heart failure(
P<0.05). According to grading scheme of New York Heart Association(NYHA), cardiac function of COPD combined with heart failure group was divided into grade Ⅰ to Ⅳ. The levels of serum hs-CRP and NT proBNP in COPD had an increase trend in Ⅳ, Ⅲ, Ⅱ and Ⅰ, and the level of GFR had an decrease trend in Ⅳ, Ⅲ, Ⅱ and Ⅰ(
P<0.05).
Conclusion Analysis in changes of serum hs-CRP, NT-proBNP and GFR levels in patients with COPD combined with heart failure can effectively reflect cardiac function status and its severity.