摘要
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 observe the frequency and severity of carotid atherosclerotic stenosis in senior chronic obstructive pulmonary disease（ COPD） patients and explore the related risk factors in order to provide a theoretical basis for the effective prevention of cardiovascular comorbidity in COPD. Methods Stable COPD out-patients followed up in Sichuan Provincial People＇s Hospital were prospectively enrolled between August 2012 and August 2015,who had carotid atherosclerosis confirmed by cervical vascular color ultrasonic inspection within 3 months. All the patients were divided into a carotid stenosis group and a noncarotid stenosis group. Demographic and laboratory data were extracted and compared between two groups.Pearson correlation and Logistic regression analysis were performed to analyze the risk factors related to carotid stenosis. Results Of 380 consecutive senior patients with COPD and carotid atherosclerosis,199（ 52. 37%） had carotid stenosis. Compared with those without carotid stenosis,the patients in the carotid stenosis group had significantly higher levels of hypersensitive C reactive protein（ hs-CRP）,uric acid（ UA）,brain natriuretic peptide（ BNP） and smoking index（ P〈 0. 05）. Lower levels of forced expiratory volume in one second（ FEV1%） and body mass index（ BMI） were also observed in the carotid stenosis group（ P〈 0. 05）. Pearson correlation and logistic regression analysis showed that 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） were associated with carotid stenosis. Conclusions Carotid atherosclerotic stenosis is common in senior COPD patients. Higher levels of hs-CRP,UA and smoking index and lower levels of FEV_1 and BMI may be independent risk factors for carotid stenosis in COPD.
出处
《中国呼吸与危重监护杂志》
CAS
北大核心
2016年第3期236-240,共5页
Chinese Journal of Respiratory and Critical Care Medicine
基金
四川省卫生厅科研资助项目(编号:110201)
关键词
慢性阻塞性肺疾病
粥样硬化
狭窄
危险因素
Chronic obstructive pulmonary disease
Atherosclerosis
Stenosis
Risk factor
