慢性阻塞性肺疾病的严重程度对冠心病患者预后的影响的临床研究

目的探讨慢性阻塞性肺疾病（COPD）的严重程度对冠心病（CHD）患者预后的影响。方法回顾性的分析2005年1月～2010年12月我院收治的CHD患者4 500例,所有患者中合并COPD的患者950例,其中完成肺功能检查的患者900例。将其分为非COPD组（3 550例）、轻度COPD组（309例）、中度COPD组（281例）、重度COPD组（186例）和极重度COPD组（124例）。记录两组患者基本临床状况及随访期间临床事件情况。结果同非COPD组相比,COPD组年龄（69.7±10.1）比非COPD组（66.2±12.1）更大（P〈0.05）;COPD组吸烟史、高血压、缺血性脑血管病史、心衰病史等更常见（P〈0.05）。终点事件随访（包括全因死亡、心源性死亡、复发心肌缺血事件）显示：极重度组发生率最高,随后依次为重度组、中度组、轻度组。但各组均高于非COPD组,差异具有统计学意义（P〈0.05）。结论COPD的严重程度能够影响CHD患者的预后,随着严重程度的增加,CHD患者的死亡率及复发心肌缺血事件明显增加。

Investigation the effects of clinical severity of COPD to the outcomes of coronary heart disease

Objective To investigate the influence of the clinical severity of chronic obstructive pulmonary diseases(COPD) to outcomes of coronary heart disease(CHD).Methods 4 500 patients of CHD in our hospital from January 2005 to December 2010 were reviewed.The number of patients combined with COPD were 950,of whom 900 patients completed Pulmonary Function Tests.Among these 900 patients,there were 124 very severe COPD patients,186 severe COPD patients,281 moderate COPD patients and 309 mild COPD patients.The basic clinical situations of two groups and different clinical severity of COPD cohorts were documented.Results The non-COPD group with 3 550 patients which group age was(66.2±12.1) years,the group age of COPD group with 950 patients was(69.7±10.1) years.The patients with different severity of COPD experienced significantly higher incidence of the point events interviews(all-cause mortality,cardiac mortality and recurrent myocardial ischemia event) than the patients without COPD.Severity of COPD was associated with increased mortality.Conclusion The COPD severity infect the patients’ recovery.The cardiac mortality rate and recurrent myocardial ischemia events increase with the severity of COPD.