Clinical value of fractional exhaled nitric oxide and homocysteine in the diagnosis of acute exacerbation of chronic obstructive pulmonary disease patients with pulmonary hypertension

Objective To investigate the clinical value of fractional exhaled nitric oxide (FeNO) and homocysteine (Hcy) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients with pulmonary hypertension (PH). Methods A total of 89 AECOPD patients who were admitted to Wuhu First People's Hospital from January 2019 to December 2020 were enrolled. According to their PSAP conditions, the patients were divided into three groups: group A (AECOPD patients with PASP＜30 mmHg, n=35); group B (AECOPD patients with PASP=30 mmHg-49 mmHg, n=28) and group C (AECOPD patients with PASP>50 mmHg, n=26) . Their general information was collected, while FeNO, HCY, and peripheral blood eosinophil (EOS) counts were detected and echocardiography was conducted for correlation analysis. Results There were statistical differences in FeNO and HCY among the three groups (P<0.05). According to Pearson correlation analysis, FeNO was negatively correlated with PASP and HCY (r=-0.504,P<0.01)(r=-0.476, P<0.01), while HCY was positively correlated with PASP (r=0.369, P<0.01). The diagnostic efficiency of FeNO+HCY (AUC=0.771, 95%CI: 0.665-0.878) was higher than FeNO (AUC=0.837, 95%CI: 0.749-0.925) and HCY (AUC=0.726, 95%CI:0.588-0.863). Conclusions With the increase of PASP in AECOPD patients, FeNO decreases and Hcy increases, which are involved in the pathogenesis of PH in AECOPD patients.