慢性阻塞性肺疾病急性加重合并左心室收缩功能不全的危险因素分析  

Analysis of Risk Factors for Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Left Ventricular Systolic Dysfunction

作　　者：张娇娇 李超 王芳 张硕 张军 ZHANG Jiao-jiao;LI Chao;WANG Fang;ZHANG Shuo;ZHANG Jun(The Second Department of Respiratory Medicine,the First People's Hospital of Wuhu,Wuhu 241000,Anhui,China)

机构地区：[1]芜湖市第一人民医院呼吸内二科,安徽芜湖241000

出　　处：《医学信息》2024年第15期103-106,共4页Journal of Medical Information

摘　　要：目的探讨慢性阻塞性肺疾病急性加重合并左心室收缩功能不全的相关危险因素。方法回顾性研究2020年4月-2022年4月入住于芜湖市第一人民医院呼吸内科的慢性阻塞性肺疾病急性加重患者共84例。根据左心室射血分数(LVEF)分为两组:LVEF<50%者为左室收缩功能障碍组14例,LVEF≥50%者为左室收缩功能正常组70例。比较两组年龄、性别、吸烟指数、住院时间、动脉血气分析(pH、PaO_(2)、PaCO_(2)、乳酸)、白细胞计数、C-反应蛋白(CRP)、降钙素原(PCT)、血沉(ESR)、血清白蛋白、N端脑钠肽前体(NT-proBNP),以及第一秒用力呼气容积占预计值百分比(FEV_(1)%pre)。通过Logistic回归分析其相关独立危险因素。结果两组性别、年龄、吸烟指数、白细胞计数、C-反应蛋白、降钙素原、红细胞沉降率、血气pH值及住院天数比较,差异无统计学意义(P>0.05);两组PaO_(2)、PCO_(2)、乳酸、NT-proBNP、白蛋白比较,差异有统计学意义(P<0.05);Logistic回归模型进行多因素分析显示,乳酸是慢性阻塞性肺疾病急性加重合并左心室收缩功能不全的危险因素,血清白蛋白、FEV_(1)%pre是慢性阻塞性肺疾病急性加重合并左心室收缩功能不全的保护因素。结论对于血清白蛋白低、肺功能分级高、血气分析乳酸值高的患者,应尽早行心脏彩超检查,评估患者心功能情况,根据EF值尽早采取相应的处理措施,改善患者症状。Objective To investigate the risk factors of acute exacerbation of chronic obstructive pulmonary disease complicated with left ventricular systolic dysfunction.Methods A retrospective study of 84 patients with acute exacerbation of chronic obstructive pulmonary disease admitted to the Department of Respiratory Medicine of Wuhu First People's Hospital from April 2020 to April 2022.According to left ventricular ejection fraction(LVEF),they were divided into two groups:14 patients with LVEF<50%were in the left ventricular systolic dysfunction group,and 70 patients with LVEF≥50%were in the normal left ventricular systolic function group.The age,gender,smoking index,hospitalization time,arterial blood gas analysis(pH,PaO_(2),PaCO_(2),lactic acid),white blood cell count,C-reactive protein(CRP),procalcitonin(PCT),erythrocyte sedimentation rate(ESR),serum albumin,N-terminal pro-brain natriuretic peptide(NT-proBNP),and the percentage of forced expiratory volume in the first second(FEV_(1)%pre)were compared between the two groups.Logistic regression was used to analyze the related independent risk factors.Results There were no significant differences in gender,age,smoking index,white blood cell count,C-reactive protein,procalcitonin,erythrocyte sedimentation rate,blood gas pH and hospitalization days between the two groups(P>0.05).There were significant differences in PaO_(2),PCO_(2),lactic acid,NT-proBNP and albumin between the two groups(P<0.05).Multivariate analysis by Logistic regression model showed that lactic acid was a risk factor for acute exacerbation of chronic obstructive pulmonary disease complicated with left ventricular systolic dysfunction,and serum albumin and FEV_(1)%pre were protective factors for acute exacerbation of chronic obstructive pulmonary disease complicated with left ventricular systolic dysfunction.Conclusion For patients with low serum albumin,high lung function grade and high blood gas analysis lactic acid value,echocardiography should be performed as soon as possible to evaluate the card

关 键 词：慢性阻塞性肺疾病急性加重 左心室收缩功能不全 危险因素 

分 类 号：R563.9[医药卫生—呼吸系统]