Expression of serum cholinesterase and homocysteine in patients with chronic obstructive pulmonary disease and heart failure

  Objective  To observe the expression of serum cholinesterase (CHE) and homocysteine(Hcy) in patients with chronic obstructive pulmonary disease (COPD) and heart failure (HF), and their relationships with cardiac function and prognosis.

  Methods  A total of 163 patients with COPD and HF were selected as research objects, and were divided into COPD respiratory failure stage complicating HF group (26 cases), the COPD acute exacerbation complicating HF group(78 cases) and the COPD stable complicating HF group (59 cases) according to the severity of COPD. Another 50 patients with stable COPD were selected as control group. The cardiac ultrasound, serum CHE and Hcy levels of all patients were measured. COPD complicating HF patients were divided into Ⅰ to Ⅳ grade according to the NYHA classification, and the serum CHE and Hcy levels of different New York Heart Association (NYHA) classification were compared. The sensitivity and specificity of serum CHE and Hcy were analyzed by receiver operating characteristic (ROC) curve.

  Results  There were significant differences in body mass index(BMI), heart rate, respiratory rate, cardio thoracic ratio(CTR), fractioning shortening (FS), ejection fraction (EF), ratio of early (E) and late (A) diastolic filling velocities (E/A) between COPD respiratory failure stage complicating HF group, the COPD acute exacerbation complicating HF group, the COPD stable complicating HF group and the control group (P < 0.05). The serum CHE level of COPD respiratory failure stage complicating HF group, the COPD acute exacerbation complicating HF group, the COPD stable complicating HF group and the control group increased successively, there was significant between-group difference in serum CHE level (P < 0.05). The serum Hcy level of COPD respiratory failure stage complicating HF group, the COPD acute exacerbation complicating HF group, the COPD stable complicating HF group and control group decreased successively, there was significant between-group difference in serum Hcy level (P < 0.05). The changes of serum CHE and Hcy levels are related to the severity of HF. Compared with CHE, Hcy had higher specificity, positive predictive value and accuracy. The levels of the two indicators were related to CTR, EF and FS.

  Conclusion  Serum CHE and Hcy can be used as objective indicators to evaluate COPD combined with HF, and have certain application value in judging the severity and prognosis of the disease.