常规超声心动图联合BODE指数在老年慢性阻塞性肺疾病患者心肺功能评估中的应用价值  

Application value of conventional echocardiography combined with BODE index in evaluation of cardiopulmonary function in elderly patients with chronic obstructive pulmonary disease

作　　者：王冬 施心奕 莫为春[2] 张志华[3] Wang Dong;Shi Xinyi;MO Weichun;Zhang Zhihua(Caojing CommunityHealth Center,JinshanDistrict,Shanghai,201507,P.R.China;Department of Emergency,Jinshan Hospital Affiliated to Fudan University,Shanghai,201508,P.R.China;Department of Echocardiography,Jinshan Hospital Affiliated to Fudan University,Shanghai,201508,P.R.China)

机构地区：[1]上海市金山区漕泾社区卫生中心,上海201507 [2]复旦大学附属金山医院急危重病中心,上海201508 [3]复旦大学附属金山医院心脏超声科,上海201508

出　　处：《老年医学与保健》2020年第4期572-575,共4页Geriatrics & Health Care

摘　　要：目的探讨常规超声心动图联合BODE指数在老年慢性阻塞性肺疾病(COPD)患者心肺功能评估中的应用价值。方法选取2017年1月-2018年12月复旦大学附属金山医院随访的老年稳定期COPD患者101例作为COPD组,并且根据指南再分为4个亚组:A亚组(n=25)、B亚组(n=25)、C亚组(n=25)和D亚组(n=2);另选年龄和性别匹配的健康志愿者25例作对照组。分别测量COPD患者身高、体重及肺功能指标,评估患者呼吸困难程度(MMRC)及6min步行距离(6MWD),并计算BODE指数;采用常规超声心动图测量并评估COPD患者的心脏功能;分析BODE指数与常规超声心动图参数间的关系。结果与对照组比较,COPD患者左心室射血分数(LVEF)、右室射血分数(RVEF)及面积变化分数(FAC)不同程度降低;MMRC及BODE指数随COPD严重程度明显升高,而6MWD明显降低;BODE指数与LVEF、FAC均呈负相关(rLVEF=0.881、rFAC=0.732,P<0.05)。结论C亚组和D亚组COPD患者左、右心室存在不同程度功能减退,并随着疾病分级程度增加而加重;常规超声心动图结合BODE指数能有效评估COPD病情,具有一定的临床应用价值。Objective To investigate the application value of conventional echocardiography combined with BODE index in the evaluation of cardiopulmonary function in elderly patients with chronic obstructive pulmonary disease(COPD).Methods 101 elderly patients with stable COPD who were followed up by Jinshan hospital from January 2017 to December 2018 were selected as COPD group,and they were divided into four subgroups:subgroup A(n=25),subgroup B(n=25),subgroup C(n=25)and subgroup D(n=26)according to the guidelines.Another 25 healthy volunteers matching age and gender were selected as the control group.Their height,weight and pulmonary functionweremeasured,and the degree of dyspnea(MMRC)and 6-minute walking distance(6MWD)were examined,and BODE index was calculated,cardiac function was measured by conventional echocardiography.The relationship between BODE index and parameters of conventional echocardiography was analyzed.Results Compared with the control group,the left ventricular ejection fraction(LVEF),right ventricular ejection fraction(RVEF)and area change fraction(FAC)of COPD group decreased in varying degrees;MMRC and BODE index increased significantly with the severity of COPD,while 6MWDdecreased significantly.BODE index was negatively correlated with LVEF and FAC(rLVEF=0.881,rFAC=0.732,P<0.05).Conclusion The left and right ventricles of patients with COPD in subgroups C andD have varying degrees of hypofunction,which is aggravatedwith the increase of disease grade.Conventional echocardiography combined with BODE index can effectively evaluate the condition of patients with COPD,which has certain clinical application value.

关 键 词：老年 慢性阻塞性肺疾病 BODE指数 超声心动图 

分 类 号：R563.9[医药卫生—呼吸系统] R540.45[医药卫生—内科学]