摘要
目的:探讨超声右心功能参数与慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)合并肺动脉高压(Pulmonary Hypertension,PH)患者预后的相关性。方法:回顾性选取2020年3月至2024年3月宜春新建医院收治的60例COPD合并PH患者,依据近期治疗效果分为有效组(n=39)和无效组(n=21),比较两组右心功能参数[大动脉短轴段主肺动脉内径(Main Pulmonary Artery diameter in short axis view,MPA)、右心室游离壁厚度(Right Ventricular Free Wall Thickness,RVWT)、右心室基底横径(Right Ventricular Basal Diameter,RVd1)、右心室中部横径(Right Ventricular Mid Diameter,RVd2)、右心房左右径(Right Atrial Transverse Diameter,RAd)、三尖瓣环收缩期位移(Tricuspid Annular Plane Systolic Excursion,TAPSE)]及患者血清N末端B型利钠肽前体(N-terminal pro-B-type natriuretic peptide,NT-proBNP)水平、肺功能[用力肺活量(Forced Vital Capacity,FVC)、第1秒用力呼气容积(Forced Expiratory Volume in 1 second,FEV1)、FEV1/FVC、6分钟步行距离(6-Minute Walk Distance,6MWD)]水平,采用Spearman分析评估各指标与患者近期疗效的相关性,多因素采用Logistic回归分析,采用受试者工作特征(Receiver Operating Characteristic,ROC)曲线分析各指标预测价值。结果:有效组MPA、RVWT、NT-proBNP水平均低于无效组,TAPSE水平高于无效组(P<0.05);MPA、RVWT及血清NT-proBNP水平与治疗效果均呈负相关(P<0.05),TAPSE水平与治疗效果呈正相关(P<0.05)。MPA、RVWT、NT-proBNP为影响治疗疗效的危险因素,TAPSE为影响治疗疗效的保护性因素。MPA、RVWT、TAPSE及NT-proBNP水平各指标单一预测COPD合并PH患者治疗效果的曲线下面积分别为0.783、0.773、0.795、0.760;而联合预测的曲线下面积为0.850,高于单一指标的预测曲线下面积。结论:超声右心功能参数MPA、RVWT、TAPSE及NT-proBNP对COPD合并PH患者治疗效果具有评估价值。
Objective:To explore the correlation between echocardiographic right ventricular function parameters and prognosis in patients with chronic obstructive pulmonary disease(COPD)and pulmonary hypertension(PH).Methods:A total of 60 patients with COPD and PH in the hospital were retrospectively enrolled between March 2020 and March 2024.According to short-term curative effect,they were divided into effective group(n=39)and ineffective group(n=21).The right ventricular function parameters[diameter of main pulmonary artery in short axial segment of main artery(MPA),right ventricular free wall thickness(RVWT),basal transverse diameter of right ventricle(RVd1),middle transverse diameter of right ventricle(RVd2),left-right diameter of right atrium(RAd),tricuspid annular plane systolic excursion(TAPSE)],serum NT-proBNP and lung function[forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC,6-minute walking distance(6MWD)]were compared between the two groups.The correlation between each index and short-term curative effect was evaluated by Spearman analysis,and predictive value of each index was analyzed by multivariate Logistic regression analysis and ROC curves.Results:MPA,RVWT and NT-proBNP in effective group were lower than those in ineffective group,while TAPSE was higher than that in ineffective group(P<0.05).MPA,RVWT and serum NT-proBNP were negatively correlated with the curative effect(P<0.05),while TAPSE was positively correlated with it(P<0.05).MPA,RVWT and NT-proBNP were risk factors of curative effect,while TAPSE was a protective factor.The area under the curve(AUC)values of MPA,RVWT,TAPSE and NT-proBNP for predicting curative effect in patients with COPD and PH were 0.783,0.773,0.795 and 0.760,respectively.AUC of combined detection was 0.850,greater than that of single index.Conclusion:Echocardiographic right ventricular function parameters(MPA,RVWT,TAPSE)and NT-proBNP are of evaluation value for curative effect in patients with COPD and PH.
作者
彭丽
童丽
卢童新
谢英化
龙瑞星
Peng Li;Tong Li;Lu Tong-xin;Xie Ying-hua;Long Rui-xing(Functional Department,Xinjian Hospital of Yichun,Yichun 336000,Jiangxi,China;Functional Department,Yichun Third People's Hospital,Yichun 336000,Jiangxi,China;Department of Respiratory and Critical Care Medicine,Xinjian Hospital of Yichun,Yichun 336000,Jiangxi,China)
基金
宜春市指导性科技计划项目(编号:JXYC2025KSA185)。
关键词
慢性阻塞性肺疾病
肺动脉高压
超声右心功能参数
NT-PROBNP
近期疗效
Chronic obstructive pulmonary disease
Pulmonary hypertension
Echocardiographic right ventricular function parameter
N-terminal pro-B-type natriuretic peptide
Short-term curative effect
