心血管合并症对老年慢性阻塞性肺疾病患者急性加重及预后的影响

目的 本研究旨在探讨心血管合并症对老年慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）患者急性加重及死亡率的影响.方法 本研究入选823例老年COPD患者,其中无心血管合并症COPD患者（A组）195例,合并心血管疾病COPD患者（B组）628例（心力衰竭156例、冠心病175例、心律失常126例、高血压病171例）,随访周期为1年或患者死亡,随访期间总死亡人数为70人.结果 A组COPD患者与B组COPD患者1年内平均急性加重次数分别（1.48±0.35）次、（2.41±0.43）次,差异有统计学意义（P＜0.05）;1年内死亡率分别为2.6％、10.4％,差异有统计学意义（P＜0.05）;A组与B组4个亚组COPD患者的1年内平均急性加重次数、1年内患者死亡率之间的差异均有统计学意义（P均＜ 0.05）.A组COPD重度、极重度患者相比较,1年内平均急性加重次数分别为（1.25±0.27）次、（1.70±0.29）次（P＜0.05）,1年内死亡率分别为2.8％、5.2％（P＜0.05）;B组合并心力衰竭COPD重度、极重度患者相比较,1年内平均急性加重次数分别为（1.87±0.32）次、（4.45±0.86）次（P＜0.05）,1年内死亡率分别为10.5％、19.5％ （P＜0.05）;B组合并冠心病COPD重度、极重度患者相比较,1年内平均急性加重次数分别为（1.56＋0.31）次、（2.99±0.40）次（P＜0.05）,1年内死亡率分别为8.0％、18.0％（P＜0.05）;B组合并心律失常COPD重度、极重度患者相比较,1年内平均急性加重次数分别为（1.46±0.26）次、（2.60＋0.37）次（P＜0.05）,1年内死亡率分别为5.1％、11.1％ （P＜0.05）;B组合并高血压COPD重度、极重度患者相比较,1年内平均急性加重次数分别为（1.27±0.27）次、（2.45±0.33）次（P＜0.05）,1年内死亡率分别为3.6％、7.6％（P＜0.05）.结论 心血管合并症明显增加老年COPD患者1年内急性加重次数及死亡率,极重度COPD患者1年内急性加重次数及死亡率均高于?

The influence of cardiovascular complications on acute exacerbation and prognosis of chronic obstructive pulmonary disease in elderly patients

Objective To investigate the influence of cardiovascular complications on acute exacerbation and mortality of chronic obstructive pulmonary disease （COPD） in elderly patients. Methods 823 cases of elderly patients with COPD, including 195 cases without cardiovascular complications （ Group A） and 628 cases with cardiovascular complications （Group B） （156 cases of heart failure, 175 cases of coronary heart disease, 126 cases of arrhythmia and 171 cases of hypertension）, were enrolled and then made a follow-up investigation for one year or till death. The total number of deaths was 70 during the follow-up investigation. Results The average times of acute exacerbations in Group A and Group B were （1.48±0.35） and （2.41±0.43） in one year with statistical difference （P〈0.05）, meanwhile, the mortality rates were 2.6% and 10.4%, respectively （P〈0.05）. There were statistical differences between Group A and 4 subgroups in Group B about the average times of exacerbation and mortality in one year （P〈 0.05）. The average times of acute exacerbations of severe patients and very severe patients in Group A were （1.25±0.27） and （1.70±0.29） in one year （P〈0.05）, meanwhile, the mortality rates were 2.8% and 5.2% （P〈0.05）. The average times of acute exacerbations of severe and very severe COPD both combined with heart failure in Group B were （ 1.87±0.32 ） and （ 4.45±0.86 ） in one year （P〈0.05）, meanwhile, the mortality rates were 10.5% and 19.5 % （P 〈 0.05）. The average times of acute exacerbations of severe and very severe COPD both combined with coronary heart disease in Group B were （1.56＋0.31） and （2.99±0.40） in oneyear （P〈0.05）, meanwhile, the mortality rates were 8.0 % and 18.0 % （P 〈 0.05）. The average times of acute exacerbations of severe and very severe COPD both combined with arrhythmia in Group B were （1.46±0.26） and （2.60±0.37） in one year （P〈0.05）, meanwhile, the mortality rates were 5.1% and 11.