慢阻肺伴左心衰竭临床特征与影响因素分析  

Clinical Characteristics and Influencing Factors of Chronic Obstructive Pulmonary Disease with Left Heart Failure

作　　者：李双双 李超 来静 李娜[3] 张怡 LI Shuang-shuang;LI Chao;LAI Jing;LI Na;ZHANG Yi(Department of Respiratory medicine,The 986 hospital of Chinese People’s Liberation Army Air Force,Xi'an,Shaanxi,710018,China;Department of Respiratory medicine,Ankang Central Hospital,Ankang,Shaanxi,725099,China;Department of Clinical Laboratory,The First Affiliated Hospital of Xi’an Jiaotong University,Xi'an,Shaanxi,710061,China)

机构地区：[1]中国人民解放军空军第九八六医院呼吸内科,陕西西安710018 [2]安康市中心医院呼吸内科,陕西安康725099 [3]西安交通大学第一附属医院检验科,陕西西安710061

出　　处：《现代生物医学进展》2022年第22期4326-4330,4370,共6页Progress in Modern Biomedicine

基　　金：陕西省重点研发计划项目(2021SF-312)。

摘　　要：目的:探讨慢阻肺伴左心衰竭临床特征与影响因素。方法:回顾性选择2019年1月至2020年12月来我院诊治的慢性阻塞性肺疾病患者150例。根据是否合并心衰,将150例患者分为慢阻肺伴左心衰竭组(A组)与慢阻肺未伴左心衰竭组(B组)。分析150例患者中慢阻肺伴左心衰竭的占比,分析对比两组一般资料、习惯和疾病病史、肺功能、心脏彩超、心电图结果、血液指标水平与动脉血气指标,采用Logistic回归分析慢阻肺伴左心衰竭的影响因素。结果:(1)150例患者中,慢阻肺伴左心衰竭者占比为32.00%,慢性阻塞性肺疾病未合并左心衰竭者占比为68.00%。(2)两组性别、年龄、患病时间、糖尿病史、吸烟史、高血压史、冠心病史、FEV_(1)/FVC、左房内径、左心室舒张末内径、左室重量分数、左室后壁厚度、肺动脉压、血小板计数、C反应蛋白、降钙素原、凝血酶原时间、D-二聚体、白蛋白、肌酸激酶同工酶、N末端脑钠肽前体、Pa CO_(2)、Pa O_(2)、Sa O_(2)对比有差异(P<0.05)。(3)Logistic回归分析结果表明、性别、年龄、糖尿病史、吸烟史、高血压史、冠心病史、左心室舒张末内径、肺动脉压是影响慢阻肺合并左心衰竭患者的影响因素(P<0.05)。结论:慢阻肺伴左心衰竭的占比较高,其与性别为男性、年龄偏大、有糖尿病史、吸烟史、高血压史、冠心病史、左心室舒张末内径升高、肺动脉压升高相关,需对以上因素给予积极干预及治疗。Objective:To explore the clinical features and influencing factors of chronic obstructive pulmonary disease with left heart failure.Methods:A total of 150 patients with chronic obstructive pulmonary disease who came to our hospital for diagnosis and treatment from January 2019 to December 2020 were retrospectively selected.According to whether the patients were complicated with heart failure,150 patients were divided into COPD with left heart failure group (group A) and COPD without left heart failure group(group B).The proportion of chronic obstructive pulmonary disease with left heart failure in 150 patients was analyzed,and the general data,habits and disease history,pulmonary function,echocardiography,electrocardiogram results,blood index levels and arterial blood gas indexes of the two groups were analyzed and compared.Risk factors for obstructive pulmonary disease with left heart failure.Results:(1) Among the 150 patients,COPD with left heart failure accounted for 32.00%,and COPD without left heart failure accounted for 68.00%.(2) The Gender,age,disease duration,diabetes history,smoking history,hypertension history,coronary heart disease history,FEV_(1)/FVC,left atrial diameter,left ventricular end-diastolic diameter,left ventricular weight fraction,left ventricular posterior wall thickness,pulmonary artery Blood pressure,platelet count,C-reactive protein,procalcitonin,prothrombin time,D-dimer,albumin,creatine kinase isoenzyme,N-terminal brain natriuretic peptide precursor,Pa CO_(2),Pa O_(2),Sa O_(2) in two groups were difference (P<0.05).(3) Logistic regression analysis showed that gender,age,history of diabetes mellitus,smoking history,history of hypertension,history of coronary heart disease,left ventricular end-diastolic diameter and pulmonary artery pressure were the risk factors for patients with COPD complicated with left cardiac insufficiency (P<0.05).Conclusion:The proportion of chronic obstructive pulmonary disease with left heart failure is high,which is related to male gender,older age,history o

关 键 词：慢性阻塞性肺疾病 左心衰竭 影响因素 临床特征 

分 类 号：R563[医药卫生—呼吸系统] R541.61[医药卫生—内科学]