论文部分内容阅读
目的了解老年慢性阻塞性肺疾病(简称慢阻肺)患者颈动脉粥样硬化伴狭窄的病变程度并探讨其危险因素。方法前瞻性选择2012年8月至2015年8月四川省人民医院呼吸门诊随访的老年慢阻肺稳定期患者,且近3个月颈部血管超声检查提示伴有颈动脉粥样硬化者。按照颈动脉是否狭窄分为狭窄组和非狭窄组。测定并对比两组人口学和实验室资料,采用Pearson相关分析和Logistic回归法分析与颈动脉狭窄相关的危险因素。结果 380例老年慢阻肺患者中,颈动脉粥样斑块伴狭窄者为199例,占52.37%。与无狭窄组相比,颈动脉狭窄组具有更高水平的血清高敏C反应蛋白(hs-CRP)、尿酸、脑钠肽(BNP)和吸烟指数,而第1秒用力呼气容积(FEV1)及体重指数(BMI)低于无狭窄组,差异有统计学意义(P<0.05)。经Pearson相关分析及Logistic回归分析逐步筛选,与颈动脉狭窄相关的因素有hs-CRP(OR 1.040,95%CI 1.011~3.070)、UA(OR 1.003,95%CI 1.000~2.006)、FEV1(OR 0.899,95%CI 0.200~5.722)、吸烟指数(OR 1.002,95%CI 1.001~2.904)和BMI(OR 0.955,95%CI 0.312~4.866)。结论颈动脉粥样硬化伴狭窄在老年慢阻肺患者中常见,高hsCRP水平、高UA水平、高吸烟指数,低FEV_1水平及低BMI可能是其独立危险因素。
Objective To understand the severity of carotid atherosclerosis and stenosis in elderly patients with chronic obstructive pulmonary disease (COPD) and to explore the risk factors. Methods The prospective COPD patients in our Respiratory Clinic from Sichuan Provincial People’s Hospital from August 2012 to August 2015 were prospectively selected, and the neck vascular ultrasound examination in the past 3 months was associated with carotid atherosclerosis. According to whether the carotid artery stenosis is divided into stenosis group and non-stenosis group. The demographic and laboratory data of two groups were measured and compared. Pearson correlation analysis and logistic regression analysis were used to analyze the risk factors related to carotid stenosis. Results Among 380 elderly COPD patients, there were 199 cases (52.37%) with carotid atherosclerotic plaque and stenosis. The carotid stenosis group had higher levels of serum hs-CRP, uric acid, brain natriuretic peptide (BNP), and smoking index compared with no stenosis group, while forced expiratory volume in 1 second (FEV 1) And body mass index (BMI) were lower than those without stenosis, the difference was statistically significant (P <0.05). The results of Pearson correlation analysis and logistic regression analysis showed that the factors associated with carotid artery stenosis were hs-CRP (OR 1.040,95% CI 1.011-3.070), UA (OR 1.003,95% CI 1.000-2.006), FEV1 (OR 0.899, 95% CI 0.200 ~ 5.722), smoking index (OR 1.002, 95% CI 1.001 ~ 2.904) and BMI (OR 0.955, 95% CI 0.312 ~ 4.866). Conclusions Carotid atherosclerosis and stenosis are common in COPD patients. High hsCRP, high UA, high smoking index, low FEV - 1 and low BMI may be independent risk factors.