心脏彩超检查对慢性阻塞性肺疾病急性加重期并发肺动脉高压的评价及影响因素分析  

Evaluation and influencing factors analysis of cardiac color ultrasonography on pulmonary hypertension in acute exacerbation of COPD

作　　者：顾涛[1] 尤雪梅 王娟 杨静兆 杨华[1] GU Tao;YOU Xuemei;WANG Juan;YANG Jingzhao;YANG Hua(Rongxian People's Hospital,Zigong City,Zigong Sichuan 643100,China)

机构地区：[1]自贡市荣县人民医院,四川自贡643100

出　　处：《中国急救复苏与灾害医学杂志》2024年第12期1584-1587,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：2020年四川科研课题(编号:S20043)。

摘　　要：目的探讨心脏彩超检查对慢性阻塞性肺疾病急性加重期(AECOPD)并发肺动脉高压(PH)的评价,并分析AECOPD并发PH的影响因素。方法选取2020年1月—2022年12月在四川省自贡市荣县人民医院诊治的AECOPD患者112例,按照是否并发PH分为并发PH组29例和未并发PH组83例,均行心脏彩超检查,比较两组心脏彩超检查右心参数,分析心脏彩超检查对合并PH的诊断价值,以及AECOPD并发PH的危险因素。结果以右心导管检查为金标准,心脏彩超检查,AECOPD并发PH真阳性26例,真阴性79例,诊断AUC为0.924,敏感度、特异度、准确性分别为89.66%、95.18%、93.72%。并发症组居住地、1年发作次数、中性粒细胞/淋巴细胞比值(NLR)、N末端脑利钠肽前体(NT-proBNP)、糖类相关抗原125(CA125)、右心室心肌做功指数(RIMP)、肺动脉收缩压(PASP)与未并发PH组比较,差异显著(P<0.05)。经二元Logistic回归分析,非城镇居民、发作次数≥2次、NT-proBNP、CA125是AECOPD并发PH的危险因素(P<0.05)。结论心脏彩超检查对AECOPD并发PH具有较高的诊断价值。非城镇居民、发作次数≥2次、NT-proBNP、CA125是AECOPD并发PH的危险因素,需给予干预措施以减少PH的发生。Objective To investigate the effects of color ultrasound on acute exacerbation phase of chronic obstructive pulmonary disease(AECOPD)complicated with pulmonary hypertension(PH)and the influence factors of AECOPD complicated with PH were analyzed.Methods A total of 112 patients with AECOPD diagnosed and treated in Rongxian People's Hospital of Zigong City,from January 2020 to December 2022 were selected,used the diagnostic criteria of PH as the gold standard,and divided into 29 patients in the PH concurrence group and 83 patients in the PH concurrence group according to whether or not they received cardiac color ultrasound examination.The parameters of right heart examination by cardiac color ultrasound examination in the two groups were compared to analyze the diagnostic value of cardiac color ultrasound examination for PH concurrence.And risk factors for AECOPD with PH.Results Right heart cath ete rization was used as the gold standard,in the examination of heart color ultrasound,26 cases of true positive and 79 cases of true negative PH were complicated with AECOPD.The diagnostic AUC was 0.924,and the sensitivity,specificity and accuracy were 89.66%,95.18%and 93.72%,respectively.The rate of complications in non-urban residents,the rate of≥2 attacks in 1 year,neutrophil/lymphocyte ratio(NLR),N-terminal brain natriuretic peptide precursor(NT-proBNP)and carbohydrate-associated antigen 125(CA125).The right ventricular word index(RIMP)and pulmonary artery systolic blood pressure(PASP)in PH complicated group were significantly higher than those in no PH complicated group(P<0.05)in the complication group were significantly higher than those in non-complicated PH group(P<0.05).By binary Logistic regression analysis,non-urban residents,the number of attacks≥2 times,NT-proBNP,CA125 were the risk factors for AECOPD complicated with PH(P<0.05).Conclusion Cardiac color ultrasound can be used to diagnose AECOPD complicated with PH by RIMP and PASP.Cardiac color ultrasound has high diagnostic value for AECOPD complicated

关 键 词：慢阻肺急性加重期 肺动脉高压 心脏彩超 诊断 

分 类 号：R563.9[医药卫生—呼吸系统]