心血管合并症对老年慢性阻塞性肺疾病患者死亡风险影响  

Effect of cardiovascular complications on death risk in elderly patients with COPD

作　　者：张文书[1] 易英 马敏[1] 

机构地区：[1]四川省成都市第六人民医院心内科,四川成都610051

出　　处：《吉林医学》2017年第10期1826-1828,共3页Jilin Medical Journal

摘　　要：目的:观察老年慢性阻塞性肺疾病(COPD)合并心血管疾病患者1年内急性加重及死亡风险,探讨心血管疾病对老年COPD患者预后的影响。方法:选取老年COPD患者,依据是否合并心血管疾病分为A、B组,A组合并心血管疾病100例,B组无心血管疾病合并症31例,A组根据不同心血管疾病分为四个亚组A1冠心病组(n=27)、A2心力衰竭组(n=24)、A3心律失常组(n=20)、A4高血压组(n=29),均随访1年,观察记录随访期间患者死亡率及急性加重次数,分析死亡相关危险因素。结果:A合并心血管疾病组1年内急性加重次数、死亡率均明显高于B未合并心血管疾病组(t=9.574,χ~2=4.165 5,P<0.05);1年内急性加重次数、死亡率在A组四个亚组间比较A2组>A1组>A3组>A4组(F=11.129,χ~2=8.042,P<0.05),淋巴细胞计数、合并心血管疾病、C-反应蛋白(CRP)水平为老年COPD患者死亡的独立危险因素,差异有统计学意义(P<0.05)。结论:合并心血管疾病为老年COPD患者死亡的独立危险因素,老年COPD患者合并心血管疾病1年内死亡风险增加,尤其合并心力衰竭老年患者。Objective By observing acute exacerbations and mortality during one year in elderly COPD patients combined with cardiovascular diseases,to explore the prognostic impact of cardiovascular diseases in COPD elderly patients. Method COPD elderly patients were selected. Depending on whether combined with cardiovascular disease patients were divided into A and B group. 100 patients in group A with cardiovascular disease,while 31 patients in group B without cardiovascular diseases. Group A were divided into four subgroups depending on cardiovascular diseases,A1 CAD group with 27 patients,while 24 patients in A2 heart failure group,A3 arrhythmia group with 20 patients,while 29 patients in A4 hypertension group. The mortality and acute exacerbations in 1 year follow-up period were recorded. Risk factors related to mortality in COPD elderly patients were analyzed. Results The mortality rate and exacerbations in A group was remarkably different from that in group B（ t = 9. 574,χ~2=4. 165 5,P〈 0. 05）. The mortality rate and exacerbations in group A2 was remarkably different from that in A1,A3,A4 group（ F= 11. 129,χ~2= 8. 042,P〈 0. 05）. High CRP level,combined with cardiovascular diseases,low lymphocyte count was independent risk factor of death in COPD elderly patients（ P〈 0. 05）. Conclusion Combined with cardiovascular diseases is independent risk factor of death in elderly patients with COPD. Cardiovascular diseases increase risk of death within one year,particularly in elderly COPD patients with heart failure.

关 键 词：慢性阻塞性肺疾病 心血管疾病 死亡风险 

分 类 号：R54[医药卫生—心血管疾病] R563.9[医药卫生—内科学]