COPD患者左心功能影响因素分析

目的探究慢性阻塞性肺疾病(COPD)患者左心功能影响因素。方法选择2015年4月-2018年3月我院收治的88例COPD患者,收集患者一般资料、肺功能指标及心功能参数,比较合并肺心病及不合并肺心病患者临床资料差异,分析心功能参数及临床资料相关性。结果肺心病组患者年龄、COPD病程及合并高血压比例显著高于非肺心病患者(P<0.05);肺心病组患者第一秒用力呼吸容积(FEV_1)、第一秒用力呼吸容积(FEV_1)/用力肺活量(FVC)等肺功能指标及左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、舒张早期血流速度峰值/舒张晚期血流速度峰值(E/A)等心功能参数指标均显著低于非肺心病组(P<0.05);相关性分析示,年龄、是否合并高血压与LVEDD、E/A等心功能指标呈负相关(P<0.05);FEV_1与LVEDD、LVEF、E/A等心功能指标均呈正相关(P<0.05);FEV_1/FVC与LVEDD呈正相关(P<0.05);多元逐步回归分析显示,年龄、高血压、FEV_1为LVEDD的影响因素(P<0.05);年龄、高血压为心功能E/A的影响因素(P<0.05)。结论年龄、高血压及肺功能下降为影响COPD患者左心功能的危险因素。

Analysis of Factors Affecting the Left Ventricular Function in Patients with COPD

Objective To investigate the influencing factors of left ventricular function in patients with chronic obstructive pulmonary disease (COPD). Methods A total of 88 patients with COPD who were admitted to the hospital from April 2015 to March 2018 were enrolled in the study. The general data of patients, pulmonary function parameters and cardiac function parameters were collected. The clinical data of patients with pulmonary heart disease and those without were compared. The correlation between cardiac function parameters and clinical data was analyzed. Results The age, duration of COPD and proportion of hypertension in pulmonary heart disease group were significantly higher/longer than those in non-pulmonary heart disease group ( P <0.05). The pulmonary function parameters such as forced expiratory volume in 1 second (FEV 1) and the ratio of FEV 1 to forced vital capacity (FVC), cardiac function parameters such as left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF) and peak value of early diastolic blood flow velocity/peak value of advanced diastolic blood flow velocity (E/A) in the pulmonary heart disease group were significantly lower than those in the non-pulmonary heart disease group ( P <0.05 ).Correlation analysis showed that age and hypertension were negatively correlated with cardiac function parameters such as LVEDD and E/A ( P <0.05 ), while FEV 1 was positively correlated with cardiac function parameters such as LVEDD, LVEF and E/A ( P <0.05 ). FEV 1/FVC was positively correlated with LVEDD ( P <0.05). Multiple stepwise regression analysis showed that age, hypertension and FEV 1 were the influencing factors of LVEDD ( P <0.05), while age and hypertension were the influencing factors of E/A in cardiac function ( P <0.05 ). Conclusion Age, hypertension and decreased pulmonary function are risk factors for left ventricular function in patients with COPD.