慢性阻塞性肺疾病合并外周血管疾病危险因素分析

目的探讨慢性阻塞性肺疾病(简称慢阻肺)患者合并外周血管疾病的危险因素。方法回顾性分析2013年5月至2018年5月兰州大学第一医院慢阻肺并接受外周血管检查的805例患者资料,根据检查部位及结果分组。比较患者临床资料,对差异具有统计学意义的因素行多因素Logistic回归分析危险因素。结果 (1)慢阻肺行颈动脉超声检查患者231例,其中80.95%合并颈动脉粥样硬化(CAS),慢阻肺CAS组合并高血压以及年龄、白细胞计数、中性粒细胞比例、纤维蛋白原(FIB)高于慢阻肺无CAS组,总胆固醇及高密度脂蛋白低于慢阻肺无CAS组。Logistic回归分析示合并高血压及高龄、高白细胞是慢阻肺患者合并CAS的危险因素。(2)慢阻肺行下肢动脉超声检查患者86例,其中72.09%合并下肢动脉疾病(PAD),慢阻肺PAD组合并高血压、高脂血症以及年龄高于慢阻肺无PAD组。Logistic回归分析示合并高脂血症是慢阻肺患者合并PAD的危险因素。(3)慢阻肺行下肢静脉超声检查患者419例,其中11.93%合并下肢深静脉血栓(DVT),慢阻肺DVT组白细胞计数、中性粒细胞比例、D-二聚体高于慢阻肺无DVT组。Logistic回归分析示高中性粒细胞比例是慢阻肺患者合并DVT的危险因素。(4)慢阻肺行计算机断层肺动脉造影(CTPA)检查患者69例,其中34.78%合并肺栓塞(PE),慢阻肺PE组合并DVT比例以及D-二聚体水平高于慢阻肺无PE组。Logistic回归分析示合并DVT是慢阻肺患者合并PE的危险因素。结论慢阻肺患者外周血管疾病高发,合并高血压、高脂血症、高龄、高白细胞、高中性粒细胞比例是慢阻肺患者合并外周血管疾病的危险因素。

Analysis of risk factors for chronic obstructive pulmonary disease complicated with peripheral vascular disease

Objective To investigate the risk factors of peripheral vascular disease in patients with chronic obstructive pulmonary disease(referred to as COPD). Methods We retrospectively analyzed the data of 805 patients with COPD who underwent peripheral vascular examination. According to the examination site and results, they were divided into different groups. The clinical datas of the patients were compared, and multivariate Logistic regression analysis was performed for the factors with statistically significant differences. Results(1) There were 231 patients with COPD who underwent carotid ultrasonography, and the prevalence of CAS was 80.95%. The proportion of patients with hypertension, the age, white blood cell count, neutrophil ratio, fibrinogen(FIB) in COPD combined with CAS group were higher than those in COPD without CAS group, while the total cholesterol and high-density lipoprotein were lower than those in COPD without CAS group.Logistic regression analysis showed that combination with hypertension, high white blood cells and old age were risk factors for CAS in patients with COPD.(2) There were 86 patients with COPD who underwent lower extremity arterial ultrasonography, and the prevalence of PAD was 72.09%. The proportion of patients with hypertension, with hyperlipidemia,and the age in COPD combined with PAD group were higher than those in the COPD without PAD group. Logistic regression analysis showed that combination with hyperlipidemia was a risk factor for PAD in patients with COPD.(3)There were 419 patients with COPD who underwent lower extremity venous ultrasonography, and the prevalence of lower extremity DVT was 11.93%. The white blood cell count,neutrophil ratio and D-dimer in COPD combined with DVT group were higher than those in COPD without DVT group.Logistic regression analysis showed that high neutrophil ratio was a risk factor for DVT in patients with COPD.(4) There were69 patients with COPD who underwent CT pulmonary angiography(CTPA), the prevalence of PE was 34.78%. The proportion of patients with DVT and D-dimer in COPD combined with PE group were higher than those in COPD without PE group.Logistic regression analysis showed that combined DVT was risk factor for PE in patients with COPD. Conclusions The incidence of peripheral vascular disease is high in patients with COPD. Combined with hypertension, hyperlipidemia, and old age, high white blood cell count, and high neutrophil ratio are risk factors for patients with COPD and peripheral vascular disease.