慢阻肺合并肺动脉高压患者机体炎性反应与肺阻力的相关性

目的:观察慢阻肺合并肺动脉高压患者机体炎性反应指标及与肺阻力相关指标表达,分析患者炎性反应与肺阻力的相关性。方法:回顾性选取医院收治的116例慢阻肺患者病历资料,根据患者是否合并肺动脉高压将其分为非肺动脉高压组(59例)和肺动脉高压组(57例)。抽取两组患者清晨空腹静脉血,检测炎性反应指标中的C反应蛋白(CRP)、白细胞计数(WBC)、降钙素原(PCT)、白细胞介素-6(IL-6)以及血沉(ESR),并进行对比;检测两组患者肺阻力指标振荡频率5 Hz下的气道粘性阻力实测值占预计值的百分比R_5占预计值(%)]、振荡频率5 Hz与共振频率(Fres)之间电抗X曲线下面积(AX),振荡频率在5 Hz的肺弹性阻力(X₅),并进行对比。分析炎性反应相关指标与肺阻力指标的相关性。结果:肺动脉高压组CRP、WBC、PCT及IL-6水平均高于非肺动脉高压组,ESR低于非肺动脉高压组,差异有统计学意义(t=16.243,t=12.413,t=6.726,t=32.670,t=10.102;P<0.05);肺动脉高压组R5占预计值(%)、AX及X₅均高于非肺动脉高压组,差异有统计学意义(t=19.770,t=8.230,t=19.685;P<0.05);相关检验结果显示,慢阻肺合并肺动脉高压患者CRP、WBC、PCT及IL-6水平与R_5占预计值%、AX及X₅值呈正相关,ESR水平与R_5占预计值%、AX及X₅值呈负相关。结论:慢阻肺合并肺动脉高压患者常伴不同程度的炎性反应与肺阻力,且炎性反应程度与患者肺阻力间呈明显相关性,炎性因子检测可能对评估慢阻肺合并肺动脉高压患者的肺阻力情况有一定价值,可指导临床诊治。

Correlation between inflammatory response and pulmonary resistance in patients with COPD combined with PAH

Objective:To observe the expressions of inflammatory response indicators and pulmonary resistance indicators in patients with chronic obstructive pulmonary disease(COPD)combined with pulmonary arterial hypertension(PAH),and to analyze the correlation between inflammatory response and pulmonary resistance.Methods:The medical record data of 116 patients with COPD who admitted to hospital were retrospectively collected.The patients were divided into two groups according to PAH occurrence,and 59 patients with simple COPD were divided into non-PAH group,and 57 patients with COPD combined with PAH were divided into PAH group.The morning fasting venous bloods of all patients were extracted,and the inflammatory response indexesC-reactive protein(CRP),white blood cell count(WBC),procalcitonin(PCT),interleukin-6(IL-6)and erythrocyte sedimentation rate(ESR)]were detected and compared.The percent of actual measurement value of viscosity resistance of airway to predicted value under the oscillation frequency 5Hz of lung resistance indicator(R5%pred),area under the reactance X(AX)curve between oscillation frequency 5Hz and resonant frequency(Fres)and lung elasticity resistance under the 5Hz oscillation frequency of two groups were detected and compared.The correlations between inflammatory response indicators and pulmonary resistance indicators were analyzed.Results:The levels of CRP,WBC,PCT and IL-6 of PAH group were significantly higher than those in non-PAH group,and the ESR of PAH group was significantly lower than that of non-PAH group(t=16.243,t=12.413,t=6.726,t=32.670,t=10.102,P<0.05).The R5%pred,AX and X5 of PAH group were significantly higher than those of non-PAH group(t=19.770,t=8.230,t=19.685,P<0.05).Relevant test results showed that CRP,WBC,PCT,IL-6 levels in patients with COPD combined with PAH were positively correlated with R5%pred,AX and X5,respectively.And the ESR level was negatively correlated with R5%pred,AX and X5.Conclusion:Patients with COPD combined with PAH are often accompanies by different degrees of inflammatory response and pulmonary resistance,and the degree of inflammatory response significantly correlates with pulmonary resistance of patients.The detection of inflammatory factors may have a certain value in assessing the pulmonary resistance of patients with COPD combined with PAH,and it can guide clinical diagnosis and treatment.