The predictive value of small pulmonary vessel parameters evaluated by CT for pulmonary hypertension in the patients with acute exacerbation of chronic obstructive pulmonary disease
Qian Jun
Sun Kai
Abstract：Objective To investigate the predictive value of small pulmonary vessel parameters assessed by CT for pulmonary hypertension(PH)in the patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 141 patients with AECOPD admitted to Emergency Department,the First Affiliated Hospital of Nanjing Medical University from September 2021 to March 2024 were retrospectively screened.According to whether PH occurred,they were divided into a combined group(n=62)and a control group(n=79).Gender,age,body mass index(BMI),length of hospital stay,the severity of AECOPD,the history of living habits,the history of underlying diseases,the history of medication and laboratory indicators were collected,small pulmonary vessel cross-sectional area(CSA)were evaluated by CT.Logistic regression analysis was used to analyze the influencing factors in the AECOPD patients with PH.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of CSA for PH.Results The hospitalization time and a course of antibiotics in the combined group were longer than those in the control group(P＜0.05).The proportion of AECOPD severity(grade Ⅱ and grade Ⅲ),white blood cell(WBC),hemoglobin(Hb),D-dimer,arterial partial pressure of carbon dioxide(PaCO2)and％CSA5～10 in the combined group were higher than those in the control group(P＜0.05),while lymphocyte(LYM)and％CSA＜5 in the combined group were lower than those in the control group(P＜0.05).Logistic regression analysis showed that LYM(OR=0.046,95％CI 0.011-0.321),Hb(OR=1.065,95％CI 1.017-1.567),％CSA＜5(OR=0.043,95％CI 0.011-0.674),％CSA5～10(OR=1.332,95％CI 1.023-4.443)were the influencing factors in the AECOPD patients with PH(P＜0.05).ROC curve analysis showed that％CSA＜5 had a slightly higher predictive efficiency than％CSA5～10 in the patients with PH[AUC 0.771(0.667-0.875)vs.0.680(0.568-0.792)],with the sensitivity of 0.875,the specificity of 0.745,Youden index of 0.620,P＜0.001.Conclusions％CSA＜5 is associated with PH in the AECOPD patients,suggesting that％CSA＜5 may have a certain predictive value in clinical practice.
Keywords：Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)Pulmonary hypertensionSmall pulmonary vesselsChest CT
Publication Date：2025-03-09
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 232-236 )