慢性阻塞性肺疾病急性加重期患者心功能不全相关危险因素及其与预后的关系

Related risk factors of cardiac insufficiency in patients with acute exacerbation of chronic obstructive pulmonary disease and their relationships with prognosis

  • 摘要:
      目的  分析慢性阻塞性肺疾病急性加重期(AECOPD)患者心功能不全相关危险因素及其与预后的关系。
      方法  选取104例AECOPD患者为研究对象,按照是否合并心功能不全将其分为心功能不全组(n=62)与无心功能不全组(n=42),以Logistic回归模型分析AECOPD患者心功能不全影响因素及AECOPD患者预后影响因素。
      结果  心功能不全组与无心功能不全组COPD确诊时间、近1年之内急性加重次数、低白蛋白血症、血二氧化碳分压pa(CO2)、C反应蛋白(CRP)水平比较,差异有统计学意义(P < 0.05);pa(CO2)、近1年之内急性加重次数、低白蛋白血症是AECOPD患者心功能不全的独立危险因素(P < 0.05);预后良好组与预后较差组年龄、治疗后红细胞体积分布宽度(RDW)与血清尿酸(UA)、低白蛋白血症、肺功能分级、心功能不全及纽约心脏病学会(NYHA)心功能分级比较,差异有统计学意义(P < 0.05);年龄、低白蛋白血症、肺功能分级、心功能不全及NYHA心功能分级是AECOPD患者预后的独立危险因素(P < 0.05)。
      结论  AECOPD患者心功能不全主要危险因素为pa(CO2)升高、近1年之内急性加重次数增多及低白蛋白血症,心功能不全及严重程度与患者预后密切相关,可增高不良预后风险。

     

    Abstract:
      Objective  To analyze the related risk factors of cardiac insufficiency in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and their relationships with prognosis.
      Methods  A total of 104 patients with AECOPD were selected as study objects, and were divided into cardiac insufficiency group (n=62) and non-cardiac insufficiency group (n=42) according to the presence or absence of cardiac insufficiency. Logistic regression model was used to analyze the influencing factors of cardiac insufficiency in patients with AECOPD, and the prognostic influencing factors of AECOPD.
      Results  There were statistically significant differences in the confirmed diagnosis time of COPD, the number of acute exacerbation in the past one year, hypoalbuminemia, partial pressure of carbon dioxidepa(CO2), and C-reactive protein (CRP) levels between the cardiac insufficiency group and non-cardiac insufficiency group (P < 0.05). The level of pa(CO2), the number of acute exacerbation in the past one year, and hypoalbuminemia were independent risk factors for cardiac insufficiency in patients with AECOPD (P < 0.05). There were statistically significant differences in age, red blood cell distribution width (RDW) and serum uric acid (UA) after treatment, pulmonary function classification, hypoalbuminemia, cardiac insufficiency and New York Heart Association (NYHA) cardiac function classification between the good prognosis group and the poor prognosis group (P < 0.05). Age, hypoalbuminemia, pulmonary function classification, cardiac insufficiency and NYHA cardiac function classification were independent risk factors influencing the prognosis of patients with AECOPD (P < 0.05).
      Conclusion  The main risk factors for cardiac insufficiency in patients with AECOPD include increased pa(CO2), increased times of acute exacerbation in the past one year, and hypoalbuminemia. Cardiac insufficiency and its severity are closely related to the patients' prognosis, which can increase the risk of poor prognosis.

     

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