广州医药 ›› 2018, Vol. 49 ›› Issue (5): 74-77.DOI: 10.3969/j.issn.1000-8535.2018.05.018

• 论著 • 上一篇    下一篇

COPD合并肺动脉高压疾病危险因素分析

陈泳华1, 曾军1, 刘春丽2, 王健2   

  1. 1 广州市第一人民医院(广州 510180);
    2 广州医科大学附属第一医院(广州 510182)
  • 收稿日期:2018-07-25 出版日期:2018-09-20 发布日期:2021-11-29

Analysis of risk factors of pulmonary hypertension associated with COPD

CHEN Yonghua1, ZENG Jun1, LIU Chunli2, WANG Jian2   

  1. 1 Guangzhou First People's Hospital, Guangzhou 510180,China;
    2 Guangzhou Medical University,First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510182, China
  • Received:2018-07-25 Online:2018-09-20 Published:2021-11-29

摘要: 目的 分析慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)合并肺动脉高压(pulmonary hypertention,PH)的危险因素。方法 回顾2014年1月—2015年1月广州医科大学附属第一医院住院患者55例,经心脏彩色多普勒超声测量肺动脉收缩压(PASP),分为:轻度组(36≤PASP<50 mmHg),中度组(51≤PASP<70 mmHg)和重度组(PASP≥70 mmHg),分析比较三组临床特征,危险因素采用单因素及多因素Logistic回归分析。结果 年龄(75.3±11.6)岁,PASP为(52.6±15.1)mmHg。单因素分析中-重度PH与年龄、HCT、PaCO2、PaO2、D-二聚体有关;多因素Logistic回归分析确定3项危险因素:HCT[比值比(OR)=51.82,95% CI: 2.34~1149.02],RV(OR=4.53,95% CI: 2.83~7.27),及PaCO2(OR=1.02,95% CI: 1.00~1.03)。结论 呼吸病相关PH多为轻-中度,高水平的HCT、RV直径及PaCO2提示PH病情较重。

关键词: 肺动脉高压, COPD, 危险因素

Abstract: Objective To analyze the clinical risk factors of pulmonary hypertension (PH) associated with chronic obstructive pulmonary disease(COPD). Methods A total of 55 hospitalized patients from 2014 to 2015 were enrolled in the study and were classified into three groups according to pulmonary artery systolic pressure (PASP) with echocardiography as follows: the mild group (36≤PASP<50 mmHg), the moderate group (51≤PASP<70 mmHg) and the severe group (PASP≥70 mmHg). Clinical data were recorded and retrospectively analyzed. Results The average age of all patients was (75.3±11.6)years. Echocardiography showed a mean PASP was 52.6±15.1 mmHg. Age, hematocrit (HCT), partial pressure of carbon dioxide (PaCO2), the oxygen partial pressure (PaO2), D-dimer and right ventricular (RV) diameter (>20 mm) were associated with moderate-to-severe PH on an univariate regression analysis, while RV (diameter >20 mm)[odds ratio (OR)=4.53, 95% CI: 2.83~7.27], HCT(OR=51.82, 95% CI: 2.34~1149.02) and PaCO2 (OR=1.02, 95% CI: 1.00-1.03), to these patients, were independent risk factors using the multiple logistic regression analysis. Conclusion PH related to respiratory diseases is mostly mild-to-moderate. Haemoptysis,high levels of RV diameter, HCT and PaCO2 suggest a serious condition of patients with PH related to chronic respiratory disease.

Key words: Pulmonary hypertension (PH), COPD, Risk factors