左心室肥厚对慢性阻塞性肺疾病急性加重期住院结果的研究  

Influence of left ventricular hypertrophy on in-hospital outcomes in acute exacerbation of chronic obstructive pulmonary disease

作　　者：张凌波[1] 谢媛媛[1] 翟福利[1] 蔡晓聪 ZHANG Lingbo;XIE Yuanyuan;ZHAI Fuli;CAI Xiaocong(Department of Respiratory Medicine,General Hospital of Chongqing Iron ＆Steel Co.Lt)

机构地区：[1]重钢总医院呼吸内科,重庆400081

出　　处：《检验医学与临床》2018年第4期513-516,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨左心室肥厚对慢性阻塞性肺疾病(COPD)急性加重期(AECOPD)患者住院结果的影响。方法选取2015年1月至2016年12月该院呼吸科61例AECOPD住院患者。按照超声心动图的左心室质量指数(LVMI),女性大于120g/m^2和男性大于125g/m^2被诊断为左心室肥厚(LVH)。相对室壁厚度(RWT)>0.42诊断为向心性肥大,RWT≤0.42诊断为扩张性肥大。对患者是否需要无创通气(NIV)、有创机械通气(MV)及其使用时间、重症监护病房(ICU)住院时间、总住院时间进行统计分析。结果 61例患者中有32例(52.5%)LVH患者和29例(47.5%)非LVH患者。LVH患者与非LVH患者在NIV和MV使用例数、NIV和MV平均使用时间、ICU住院时间和总住院时间比较,差异无统计学意义(P>0.05)。LVH患者的向心性LVH患者19例(59.4%),扩张性LVH患者13例(40.6%)。向心性LVH患者的NIV使用例数和使用时间分别为10例(52.6%)和(1.0±1.9)h,与扩张性LVH患者的2例(15.4%)和(0.6±1.4)h比较,差异有统计学意义(P<0.05),而在MV使用例数、MV使用平均时间、ICU住院时间和总住院时间上,两类患者差异无统计学意义(P>0.05)。另外,向心性LVH患者与较长NIV使用时间具有相关性(P=0.009)。结论 AECOPD的向心性LVH患者住院期间具有较高NIV使用率和使用时间,且与NIV使用时间具有高度的相关性。Objective To explore correlation between left ventricular hypertrophy（LVH）and clinical outcomes in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.Methods During January 2015 to December 2016 at department of pulmonary,61 cases with AECOPD with available echocardiographic data were included.LVH was defined as LV mass index（LVMI）〉120 g/m^2（women）and 〉125 g/m^2（men）.Wall thickness was used to classify LVH as concentric（〉0.42）or eccentric（〈0.42）.Outcomes included need for and duration of non-invasive ventilation（NIV）and mechan-ical ventilation（MV）,intensive care unit（ICU）and total length of stay.Results Of 61 patients with AECOPD,32（52.5%）patients having LVH and 29（47.5%）were included.There were no statistically significant in NIV and MV use and duration,ICU and total duration between LVH and non-LVH cohort.Of the 32 LVH patients had 19（59.4%）concentric LVH and 13（40.6%）eccentric LVH.Concentric LVH was predictive of greater NIV use[10（52.6%）vs.2（15.4%）,P〈0.01]and duration[（1.0±1.9）vs.（0.6±1.4）days,P〈0.01]compared to eccentric LVH.Concentric LVH remained independently associated with NIV duration（P=0.009）.Conclusion In-hospital outcomes in patients with AECOPD were comparable in patients with and without LVH.Patients with concentric LVH had higher NIV need and duration in comparison to eccentric LVH.

关 键 词：慢性阻塞性肺疾病急性加重期 左心室肥厚 左心室质量指数 向心性肥厚 无创通气 

分 类 号：R563[医药卫生—呼吸系统]