[1]张娇娇,李 超,王 芳,等.慢性阻塞性肺疾病急性加重合并左心室收缩功能不全的危险因素分析[J].医学信息,2024,37(15):103-106.[doi:10.3969/j.issn.1006-1959.2024.15.023]
　ZHANG Jiao-jiao,LI Chao,WANG Fang,et al.Analysis of Risk Factors for Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Left Ventricular Systolic Dysfunction[J].Journal of Medical Information,2024,37(15):103-106.[doi:10.3969/j.issn.1006-1959.2024.15.023]
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慢性阻塞性肺疾病急性加重合并左心室收缩功能不全的危险因素分析()

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年15期
页码:
103-106
栏目:
论著
出版日期:
2024-08-01

文章信息/Info

Title:
Analysis of Risk Factors for Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Left Ventricular Systolic Dysfunction
文章编号:
1006-1959（2024）15-0103-04
作者:
张娇娇; 李 超; 王 芳; 等
（芜湖市第一人民医院呼吸内二科，安徽 芜湖 241000）
Author(s):
ZHANG Jiao-jiao; LI Chao; WANG Fang; et al.
(The Second Department of Respiratory Medicine,the First People’s Hospital of Wuhu,Wuhu 241000,Anhui,China)
关键词:
慢性阻塞性肺疾病急性加重; 左心室收缩功能不全; 危险因素
Keywords:
Acute exacerbation of chronic obstructive pulmonary disease; Left ventricular systolic dysfunction; Risk factors
分类号:
R563.9
DOI:
10.3969/j.issn.1006-1959.2024.15.023
文献标志码:
A
摘要:
目的 探讨慢性阻塞性肺疾病急性加重合并左心室收缩功能不全的相关危险因素。方法 回顾性研究2020年4月-2022年4月入住于芜湖市第一人民医院呼吸内科的慢性阻塞性肺疾病急性加重患者共84例。根据左心室射血分数（LVEF）分为两组：LVEF＜50%者为左室收缩功能障碍组14例，LVEF≥50%者为左室收缩功能正常组70例。比较两组年龄、性别、吸烟指数、住院时间、动脉血气分析（pH、PaO2、PaCO2、乳酸）、白细胞计数、C-反应蛋白（CRP）、降钙素原（PCT）、血沉（ESR）、血清白蛋白、N端脑钠肽前体（NT-proBNP），以及第一秒用力呼气容积占预计值百分比（FEV1% pre）。通过Logistic回归分析其相关独立危险因素。结果 两组性别、年龄、吸烟指数、白细胞计数、C-反应蛋白、降钙素原、红细胞沉降率、血气pH值及住院天数比较，差异无统计学意义（P＞0.05）；两组PaO2、PCO2、乳酸、NT-proBNP、白蛋白比较，差异有统计学意义（P＜0.05）；Logistic回归模型进行多因素分析显示，乳酸是慢性阻塞性肺疾病急性加重合并左心室收缩功能不全的危险因素，血清白蛋白、FEV1%pre是慢性阻塞性肺疾病急性加重合并左心室收缩功能不全的保护因素。结论 对于血清白蛋白低、肺功能分级高、血气分析乳酸值高的患者，应尽早行心脏彩超检查，评估患者心功能情况，根据EF值尽早采取相应的处理措施，改善患者症状。
Abstract:
Objective To investigate the risk factors of acute exacerbation of chronic obstructive pulmonary disease complicated with left ventricular systolic dysfunction.Methods A retrospective study of 84 patients with acute exacerbation of chronic obstructive pulmonary disease admitted to the Department of Respiratory Medicine of Wuhu First People’s Hospital from April 2020 to April 2022. According to left ventricular ejection fraction (LVEF), they were divided into two groups: 14 patients with LVEF<50% were in the left ventricular systolic dysfunction group, and 70 patients with LVEF≥50% were in the normal left ventricular systolic function group. The age, gender, smoking index, hospitalization time, arterial blood gas analysis (pH, PaO2, PaCO2, lactic acid), white blood cell count, C-reactive protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR), serum albumin, N-terminal pro-brain natriuretic peptide (NT-proBNP), and the percentage of forced expiratory volume in the first second (FEV1%pre) were compared between the two groups. Logistic regression was used to analyze the related independent risk factors.Results There were no significant differences in gender, age, smoking index, white blood cell count, C-reactive protein, procalcitonin, erythrocyte sedimentation rate, blood gas pH and hospitalization days between the two groups (P>0.05). There were significant differences in PaO2, PCO2, lactic acid, NT-proBNP and albumin between the two groups (P<0.05). Multivariate analysis by Logistic regression model showed that lactic acid was a risk factor for acute exacerbation of chronic obstructive pulmonary disease complicated with left ventricular systolic dysfunction, and serum albumin and FEV1% pre were protective factors for acute exacerbation of chronic obstructive pulmonary disease complicated with left ventricular systolic dysfunction.Conclusion For patients with low serum albumin, high lung function grade and high blood gas analysis lactic acid value, echocardiography should be performed as soon as possible to evaluate the cardiac function of patients, and corresponding treatment measures should be taken as soon as possible according to the EF value to improve the symptoms of patients.

参考文献/References:

[1]李岚,姜芳,史金英,等，Tei指数及N端脑利钠肽前体评估不同程度慢性阻塞性肺疾病患者右心功能的研究[J].河北医药,2020,42(22):3421-3423,3427.[2]肖瑶,朱光发,杨娅,等.超声心动图对慢性阻塞性肺疾病患者早期右心功能异常的评估[J].中华医学超声杂志(电子版),2018,15(3):170-177.[3]张银波,惠焕晴,邵影.MRI对慢性阻塞性肺疾病患者肺动脉血流和右心功能评估的应用价值[J].医学影像学杂志,2022,32(7):1239-1242.[4]林祥兵,丁震.合并右心衰竭对慢性阻塞性肺疾病急性加重频率及严重程度的影响[J].内科急危重症杂志,2019,25(1):45-47.[5]梁芳,王在义.慢性阻塞性肺疾病对左心功能的影响[J].临床肺科杂志,2015,20(1):132-135.[6]Bhattacharyya P,Acharjee D,Ray SN,et al.Left ventricular diastolic dysfunction in COPD may manifest myocardial ischemia[J].COPD,2012,9(3):305-309.[7]Andrijevic L,Milutinov S,Andrijevic I,et al.Association Between the Inflammatory Biomarkers and Left Ventricular Systolic Dysfunction in Patients with Exacerbations of Chronic Obstructive Pulmonary Disease[J].Balkan Med J,2017,34(3):226-231.[8]慢性阻塞性肺疾病急性加重诊治专家组.慢性阻塞性肺疾病急性加重诊治中国专家共识(2023年修订版)[J].国际呼吸杂志,2023,43(2):132-149.[9]陶凤然,樊娜,蒋云雯,等.1997-2017年中国人群慢性阻塞性肺病疾病负担趋势分析[J].中国慢性病预防与控制,2020,28(1):3-9.[10]陈刚,徐永芳,徐曌,等.老年慢性阻塞性肺疾病患者左心室舒张功能与射血分数保留心力衰竭[J].中国老年学杂志,2016,36(10):2434-2436.[11]周京敏,周俊,潘文志,等.左室收缩功能正常的心房颤动患者血清NT-pro-BNP水平的变化及影响因素探讨[J].中国临床医学,2007,14(2):129-131.[12]Daniels LB,Clopton P, Bhalla V,et al.How obesity affects the cut-points for B-type natriuretic peptide in the diagnosis of acute heart failure. Results from the Breathing Not Properly Multinational Study[J].Am Heart J,2006,151(5):999-1005.[13]Vogelmeier CF,Criner GJ,Martinez FJ,et al.Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report. GOLD Executive Summary[J].Am J Respir Crit Care Med,2017,195(5):557-582.[14]Matkovic Z,Cvetko D,Rahelic D,et al.Nutritional Status of Patients with Chronic Obstructive Pulmonary Disease in Relation to their Physical Performance[J].COPD,2017,14(6):626-634.[15]Nguyen HT,Collins PF,Pavey TG,et al.Nutritional status, dietary intake, and health-related quality of life in outpatients with COPD[J].Int J Chron Obstruct Pulmon Dis,2019,14:215-226.[16]Hoong JM,Ferguson M,Hukins C,et al.Economic and operational burden associated with malnutrition in chronic obstructive pulmonary disease[J].Clin Nutrv,2017,36(4):1105-1109.[17]边明艳,郭天聪,倪楠.老年慢性阻塞性肺疾病患者营养不良发生情况及相关危险因素[J].中国卫生工程学,2023,2(22):57-59.[18]李路,杨阳,孙亚男,等.慢性阻塞性肺疾病急性加重期患者心功能不全相关危险因素及其与预后的关系[J].实用临床医药杂志,2021,25(15):43-48,52.[19]李娇,王宋平.慢性阻塞性肺疾病急性加重期患者预后的影响因素[J].中国老年学杂志,2019,39(12):2907-2910.[20]张兵华,郭玮,李永鹏,等.左心室收缩功能不全对慢性阻塞性肺疾病住院患者死亡的临床预测价值[J].临床肺科杂志,2020,25(3):329-331,346.

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更新日期/Last Update: 1900-01-01