初诊慢性阻塞性肺疾病伴高压病临床症状、生存质量及实验室指标研究  

The clinical symptoms,quality of life and laboratory indexes of newly diagnosed chronic obstructive pulmonary disease with hypertension

作　　者：毛燕青[1] 王亚楠 李洁[1] MAO Yanqing;WANG Ya′nan;LI Jie(Department of General Medicine,First Affiliated Hospital of Soochow University,Suzhou 215000,China)

机构地区：[1]苏州大学附属第一医院全科医学科,江苏苏州215000

出　　处：《实用医学杂志》2024年第11期1549-1553,1559,共6页The Journal of Practical Medicine

基　　金：江苏省卫生健康委科研项目(编号:M2022015);苏州市科技计划项目(编号:SKY2023048);苏州市医学重点扶持学科项目(编号:SZFCXK202111)。

摘　　要：目的探讨初诊慢性阻塞性肺疾病(COPD)伴高血压患者呼吸道症状、生存质量、血常规及外周血骨代谢指标特征及意义。方法选取2019年1月至2022年4月在我院治疗的初诊COPD伴高血压患者92例作为观察组,同时选取初诊无高血压的COPD患者92例作为对照组,比较两组改良版英国医学研究委员会呼吸问卷(mMRC)、COPD患者自我评估测试问卷(CAT)、COPD全球倡议(GOLD)、SF-36量表评分、血常规及骨代谢指标差异。结果观察组mMRC评级≥2级的比例、CAT评分明显高于对照组(P<0.05),而SF-36评分明显低于对照组(P<0.05)。观察组GOLD分级明显高于对照组(P<0.05),用力肺活量(FVC)和第一秒呼气量(FEV_(1))明显低于对照组(P<0.05)。观察组和对照组白细胞计数(WBC)、中性粒细胞计数(NEUT)、淋巴细胞计数(LYM)等比较差异无统计学意义(P>0.05);观察组股骨颈骨密度、血钙水平明显低于对照组(P<0.05),而甲状旁腺激素(PTH)和骨钙素(BGP)水平明显高于对照组(P<0.05)。观察组C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素(IL)-6、IL-4和IL-10明显高于对照组(P<0.05)。观察组高血压分级与mMRC评级、CAT评分和GOLD分级呈正相关(r_(s)=0.455、0.302、0.501,P<0.05),而与FVC、FEV1呈负相关(r_(s)=-0.311、-0.334,P<0.05)。结论初诊COPD伴高血压病患者呼吸症状较重,生存质量较差,发生骨质疏松风险增加,同时患者血压情况与呼吸症状程度有一定关系。Objective We tried to investigate the difference of respiratory symptoms,quality of life,blood routine examination and bone metabolism in patients with newly diagnosed chronic obstructive pulmonary disease with and without hypertension.Methods A total of 92 newly diagnosed patients with chronic obstructive pulmonary disease and hypertension treated in our hospital from January 2019 to April 2022 were selected as the observation group,and 92 newly diagnosed patients with COPD without hypertension were selected as the control group.The modified British Medical Research Council Respiratory Questionnaire(mMRC),Chronic Obstructive Pulmonary Disease Self Assessment Test Questionnaire(CAT),Global Initiative for Chronic Obstructive Pulmonary Disease(GOLD),SF-36 scale scores,blood routine examination and bone metabolism indexes were different.Results The rate of mMRC grade≥2 and CAT score of the observation group were significantly higher than those of the control group(P<0.05),while the SF-36 score was significantly lower than that of the control group(P<0.05).The GOLD grading of the observation group was significantly higher than that of the control group(P<0.05).The forced vital capacity(FVC)and the first second expiratory volume(FEV1)in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference between the observation group and the control group in white blood cell count(WBC),neutrophil count(NEUT)and lymphocyte count(LYM)etc(P>0.05).The bone mineral density of the femoral neck and blood calcium in the observation group were significantly lower than those in the control group(P<0.05),while the parathyroid hormone(PTH)and osteocalcin(BGP)were significantly higher than those in the control group(P<0.05).The levels of C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6),IL-4,and IL-10 in the observation group were significantly higher than those in the control group(P<0.05).The hypertension grade in the observation group was positively correlated

关 键 词：慢性阻塞性肺疾病 高血压 呼吸道症状 生存质量 血常规 骨代谢 

分 类 号：R563[医药卫生—呼吸系统]