慢性支气管炎合并心血管疾病的临床、肺功能和影像特征
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摘要
目的探讨慢性支气管炎合并心血管疾病患者的临床、肺功能和影像学特征。方法选择2014年10月至2017年9月诊断为慢性支气管炎的住院患者90例,根据是否合并高血压病和(或)冠心病将其分为心血管合并症组(56例)与无心血管合并症组(34例)。比较两组患者的临床资料。结果心血管合并症组患者的上一年急性加重住院次数、m MRC评分、体质指数、DLCO/VA及RV/TLC高于无心血管合并症组患者,MVV%pred、FEV1%pred、FVC%pred、MEF50%pred均低于无心血管合并症组患者(P<0.05)。两组患者的年龄、吸烟量、CAT评分、炎症指标、凝血指标、心肌损伤指标水平、FEV1/FVC、MEF25%pred、MMEF25%~75%pred、肺气肿和肺容积参数比较,差异无统计学意义(P>0.05)。结论慢性支气管炎合并心血管疾病具有更明显的呼吸系统症状和更差的肺功能。炎症指标、凝血指标、心肌损伤指标、肺气肿和肺容积参数在合并心血管疾病的慢性支气管炎患者病情评估中没有优势。
Objective To investigate the clinical, pulmonary function and imaging features in patients with chronic bronchitis combined with cardiovascular disease. Methods Ninety hospitalized patients who were diagnosed as chronic bronchitis from October 2014 to September 2017 were selected. According to whether combined with hypertension and/or coronary heart disease, the patients were divided into cardiovascular comorbidity group(56 cases) and no cardiovascular comorbidity group(34 cases). The clinical data of patients were compared between the two groups. Results The hospitalizations times of acute exacerbation in the previous year, m MRC score, body mass index, DLCO/VA and RV/TLC in the cardiovascular comorbidity group were higher than those in the no cardiovascular comorbidity group, MVV% pred,FEV1%pred, FVC%pred, MEF50%pred were lower than those in the no cardiovascular comorbidity group(P<0.05). There were no significant differences in age, smoking amount, CAT scores, the levels of inflammation indexes, coagulation indexes and myocardial injury indexes, FEV1/FVC, MEF25%pred, MMEF25%-75%pred, emphysema and lung volume parameters between the two groups(P >0.05). Conclusion Chronic bronchitis combined with cardiovascular disease has more pronounced respiratory symptoms and worse pulmonary function. Inflammation indexes, coagulation indexes, myocardial injury indexes, emphysema and lung volume parameters have no advantage in evaluation of patients with chronic bronchitis combined with cardiovascular disease.
Objective To investigate the clinical, pulmonary function and imaging features in patients with chronic bronchitis combined with cardiovascular disease. Methods Ninety hospitalized patients who were diagnosed as chronic bronchitis from October 2014 to September 2017 were selected. According to whether combined with hypertension and/or coronary heart disease, the patients were divided into cardiovascular comorbidity group(56 cases) and no cardiovascular comorbidity group(34 cases). The clinical data of patients were compared between the two groups. Results The hospitalizations times of acute exacerbation in the previous year, m MRC score, body mass index, DLCO/VA and RV/TLC in the cardiovascular comorbidity group were higher than those in the no cardiovascular comorbidity group, MVV% pred,FEV1%pred, FVC%pred, MEF50%pred were lower than those in the no cardiovascular comorbidity group(P<0.05). There were no significant differences in age, smoking amount, CAT scores, the levels of inflammation indexes, coagulation indexes and myocardial injury indexes, FEV1/FVC, MEF25%pred, MMEF25%-75%pred, emphysema and lung volume parameters between the two groups(P >0.05). Conclusion Chronic bronchitis combined with cardiovascular disease has more pronounced respiratory symptoms and worse pulmonary function. Inflammation indexes, coagulation indexes, myocardial injury indexes, emphysema and lung volume parameters have no advantage in evaluation of patients with chronic bronchitis combined with cardiovascular disease.
引文
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[9]黄群.老年慢性阻塞性肺疾病患者并发冠心病的相关因素分析[J].中国当代医药,2015,22(11):37-39.
[10]MANNINO DM,THORN D,SWENSEN A,et al.Prevalence and outcomes of diabetes,hypertension and cardiovascular disease in COPD[J].Eur Respir J,2008,32(4):962-969.
[2]葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社,2013.
[3]PU J,FUHRMAN C,GOOD WF,et al.A differential geometric approach to automated segmentation of human airway tree[J].IEEE Trans Med Imaging,2011,30(2):266-278.
[4]NAN Y,XIAOMIN X,YAN L,et al.Effect of computed tomography dose on quantitative measurement and automated segmentation of airway tree[J].J Med Imaging Health Inform,2015,5(7):1519-1523.
[5]FRANSSEN FM,ROCHESTER CL.Comorbidities in patients with COPD and pulmonary rehabilitation:do they matter[J].Eur Respir Rev,2014,23(131):131-141.
[6]周春霞,江山平.慢性阻塞性肺疾病合并心血管疾病的研究进展[J].中华结核和呼吸杂志,2015,38(1):72-75.
[7]PAUWELS RA,BUIST AS,CALVERLEY PMA,et al.Global strategy for the diagnosis,management,and prevention of chronic obstructive pulmonary disease[J].Am J Respir Crit Care Med,2001,163(5):1256-1276.
[8]蔡志芳,孙蓉.慢性阻塞性肺疾病急性发作期并冠心病患者相关指标的临床研究[J].临床肺科杂志,2015,20(7):1341-1342.
[9]黄群.老年慢性阻塞性肺疾病患者并发冠心病的相关因素分析[J].中国当代医药,2015,22(11):37-39.
[10]MANNINO DM,THORN D,SWENSEN A,et al.Prevalence and outcomes of diabetes,hypertension and cardiovascular disease in COPD[J].Eur Respir J,2008,32(4):962-969.