COPD合并肺心病检测指标的相关性分析  

Correlation analysis of detection indexes in COPD complicating pulmonary cor pulmonale

作　　者：张君国 廖立秋 高天敏 简华刚[3] 唐勋 ZHANG Junguo;LIAO Liqiu;GAO Tianmin;JIAN Huagang;TANG Xun(Department of Respiratory and Intensive Care Medicine,Fengdu Country People′s Hospital,Chongqing 408200,China;Department of Emergency Medicine,Fengdu Country People′s Hospital,Chongqing 408200,China;Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆市丰都县人民医院呼吸与危重症医学科,重庆408200 [2]重庆市丰都县人民医院急诊医学科,重庆408200 [3]重庆医科大学附属第二医院,重庆400010

出　　处：《现代医药卫生》2021年第15期2535-2539,共5页Journal of Modern Medicine & Health

基　　金：重庆市卫生健康委员会临床重点专科建设项目(2018-61)。

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)合并肺源性心脏病(肺心病)检测指标的相关性,并分析其危险因素。方法选取2016年1月至2019年12月重庆医科大学附属第二医院及丰都县人民医院收治的住院COPD合并肺心病患者110例作为病例组,选取106例无心血管疾病的COPD患者作为对照组。观察2组患者B型脑钠肽(BNP)、C反应蛋白(CRP)、超声心动图、血气分析等检测指标的差异,分析检测指标的相关性,同时采用多因素logistic回归模型分析其危险因素。结果2组年龄、性别、吸烟比例比较,差异均无统计学意义(P>0.05);病例组患者病程、吸烟时间明显长于对照组,肺功能明显差于对照组,BNP水平明显高于对照组,差异均有统计学意义(P<0.05)。2组患者CRP水平比较,差异无统计学意义(P>0.05)。病例组患者收缩期右房横径(RA)、舒张末期右室横径(RV)明显大于对照组,差异有统计学意义(P<0.05);2组患者右心室前壁厚度、肺动脉主干内径比较,差异均无统计学意义(P>0.05)。病例组患者二氧化碳分压(PCO_(2))明显高于对照组,差异有统计学意义(P<0.05);2组患者pH值、氧分压、氧饱和度比较,差异均无统计学意义(P>0.05)。BNP与RA、RV,CRP与PCO_(2),PCO_(2)与RA、RV均呈正相关(P<0.05)。病程、BNP升高、RA增大为发生COPD合并肺心病的独立危险因素(优势比=1.233、13.186、69.170,P<0.05)。结论病程、BNP、RA为COPD合并肺心病的危险因素,可为COPD合并肺心病患者的预防、诊治及预后提供重要参考。Objective To explore the detection indexes correlation of chronic obstructive pulmonary disease(COPD)complicating pulmonary cor pulmonale and to analyze its risk factors.Methods One hundred and ten patients with COPD complicating cor pulmonale in Fengdu Country People′s Hospital and Second Affiliated Hospital of Chongqing Medical University from January 2016 to December 2019 were selected as the case group and 106 cases of COPD without cardiovascular disease were selected as the control group.The differences in the detection indexes of B-type brain natriuretic peptide(BNP),C-reactive protein(CRP),echocardiography and blood gas analysis between the two groups were observed,and the correlation between the analytical indexes was analyzed.Meanwhile,the multivariate factors logistic regression model was adopted to analyzed the risk factors.Results There was no statistically significant difference in the general indexes such as the age,sex ratio and smoking ratio between the two groups(P>0.05);but the disease course and smoking time model of the case group were longer than that of the control group,and the lung function of the case group was also significantly worse than that of the control group,the BNP level in the case group was significantly higher than that in the control group,and the differences were statistically significant(P<0.05).However,CRP had no statistical difference between the two groups(P>0.05).RA and RV in the case group were significantly greater than those in the control group,and the differences were statistically significant(P<0.05).The thickness of anterior wall of right ventricle(RVAWT)and main pulmonary artery(MPA)had no statistically significantly difference between the two groups(P>0.05),PCO_(2) in the case group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05),but there were no statistically significant differences in pH,PO 2 and SO 2 between the two groups(P>0.05).BNP was positively correlated with RA and RV,CRP was positive

关 键 词：慢性阻塞性肺疾病 肺心病 临床实验室技术 相关性 

分 类 号：R563[医药卫生—呼吸系统] R446[医药卫生—内科学]