COPD合并Ⅱ型呼吸衰竭反复入院患者伴代谢性疾病特征分析  

Clinical characteristics of metabolic diseases in frequently hospitalized chronic obstructive pulmonary disease patients with typeⅡrespiratory failure

作　　者：王燕 侯松萍[2] 张明华 韩广红 刘惠荣 Wang Yan;Hou Songping;Zhang Minghua;Han Guanghong;Liu Huirong(Department of Pulmonary and Critical Care Medicine,the Fourth Central Hospital of Baoding City,Baoding 072350,China;Department of Pulmonary and Critical Care Medicine,Jilin University China-Japan Friendship Hospital,Changchun 130000,China;Department of Endocrine,the Fourth Central Hospital of Baoding City,Baoding 072350,China;Department of Infectious Diseases,the Fourth Central Hospital of Baoding City,Baoding 072350,China)

机构地区：[1]保定市第四中心医院呼吸与危重症医学科,保定072350 [2]吉林大学中日联谊医院呼吸与危重症医学科,长春130000 [3]保定市第四中心医院内分泌科,保定072350 [4]保定市第四中心医院感染疾病科,保定072350

出　　处：《国际呼吸杂志》2022年第8期569-574,共6页International Journal of Respiration

基　　金：2021年度河北省医学科学研究课题计划项目(20211708)。

摘　　要：目的比较COPD合并Ⅱ型呼吸衰竭反复入院与非反复入院患者在合并代谢性疾病方面的差异。方法本研究为病例对照研究。采用非随机抽样法,选取2019年5月1日至2020年5月1日保定市第四中心医院呼吸与危重症医学科收治的COPD合并Ⅱ型呼吸衰竭住院患者102例,其中COPD合并Ⅱ型呼吸衰竭反复入院组50例,非反复入院组52例。比较2组间合并2型糖尿病、空腹血糖受损、糖耐量减低、低血糖、低白蛋白血症、血脂异常和脂蛋白异常血症、电解质代谢紊乱、高尿酸血症等疾病的差异。结果反复入院组患者在合并2型糖尿病、空腹血糖受损或糖耐量减低、低血糖与低钠血症方面与非反复入院组相比,差异有统计学意义(P值均<0.05)。在合并低白蛋白血症、血脂异常和脂蛋白异常血症、高尿酸血症、低钾血症、低氯血症、低钙血症、高磷血症、低磷血症、低镁血症方面差异无统计学意义(P值均>0.05)。反复入院组应用二甲双胍、阿托伐他汀治疗比例低于非反复入院组(χ^(2)值分别为5.68、4.82,P值均<0.05)。合并IFG或IGT、应用阿托伐他汀治疗为COPD合并Ⅱ型呼吸衰竭反复入院的独立影响因素(P值均<0.05)。结论与非反复入院组相比,COPD合并Ⅱ型呼吸衰竭反复入院患者合并低血糖和低钠血症比例更多,而合并高血糖、应用二甲双胍及阿托伐他汀治疗者较少。合并IFG或IGT、应用阿托伐他汀治疗可能降低COPD合并Ⅱ型呼吸衰竭患者反复入院风险。Objective To analyze the differences of metabolic diseases between frequently hospitalized chronic obstructive pulmonary disease(COPD)patients with typeⅡrespiratory failure and infrequently hospitalized patients.Methods This study was a case-control study.Non random sampling method was adopted.From May 1,2019 to May 1,2020,a total of 102 cases of COPD patients with typeⅡrespiratory failure admitted to the Department of Pulmonary and Critical Care Medicine in the Fourth Central Hospital of Baoding city were enrolled.There were 50 patients in the repeated admission group and 52 patients in the non-repeated admission group.The differences of type 2 diabetes,impaired fasting glucose,impaired glucose tolerance,hypoglycemia,hypoalbuminemia,dyslipidemia,electrolyte metabolism disorder,and hyperuricemia between the two groups were compared.Results There were significant statistical differences between the repeated admission group and the non-repeated admission group in type 2 diabetes,impaired fasting glucose or impaired glucose tolerance,hypoglycemia,and hyponatremia(all P<0.05).There was no significant difference in hypoalbuminemia,dyslipidemia,hyperuricemia,hypokalemia,hypochloremia,hypocalcemia,hyperphosphatemia,hypophosphatemia and hypomagnesemia(all P>0.05).The proportion of patients treated with metformin and atorvastatin in the repeated admission group was lower than that in the non-repeated admission group(χ^(2)=5.68,4.82,both P<0.05).Combination of IFG or IGT and atorvastatin treatment were independent factors of repeated hospitalization of COPD complicated with typeⅡrespiratory failure(all P<0.05).Conclusions Compared with the non-repeated admission group,in repeated admission group more COPD patients with typeⅡrespiratory failure had hypoglycemia and hyponatremia,and less patients had hyperglycemia and application of metformin and atorvastatin.Combination of IFG or IGT and atorvastatin treatment may reduce the risk of repeated hospitalization in COPD patients complicated with typeⅡrespiratory failu

关 键 词：肺疾病 慢性阻塞性 Ⅱ型呼吸衰竭 共患病 低血糖 代谢性疾病 

分 类 号：R563.9[医药卫生—呼吸系统] R563.8[医药卫生—内科学]