慢性阻塞性肺疾病患者肺动脉扩张与肺功能的关系

Abstract

目的 探讨慢性阻塞性肺疾病(COPD)患者肺动脉扩张和肺功能的关系.方法 收集2012年12月至2016年6月青岛市第八人民医院呼吸内科病房住院的COPD急性发作患者共78例,根据肺CT提示是否有肺动脉扩张[肺动脉(PA)＞3.0 cm],将他们分成两组,即肺动脉扩张组(n＝38)和肺动脉正常组(n＝40),分别测量并记录两组研究对象的PA直径等相关数据.比较患者在稳定期的肺功能[1秒用力呼气容积(FEV1),用力肺活量(FVC)]变化.结果 男性肺动脉扩张组FEV1测定值为(1.08 ±0.44)L,肺动脉正常组FEV1测定值为(1.44 ±0.66)L,两组差异有统计学意义(t＝2.27,P＝0.028).女性肺动脉扩张组FEV1测定值为(0.90 ±0.41)L,肺动脉正常组FEV1测定值为(1.35 ±0.58)L,两组差异有统计学意义(t＝2.28,P＝0.026).通过相关性分析发现,肺动脉直径与FEV1/FVC呈负相关(r＝-0.509,P＝0.001),即肺动脉扩张与肺功能下降相关.结论 肺动脉扩张的COPD患者肺功能下降更为明显,需要及早治疗.

Objective To investigate the relationship between pulmonary arterial ( PA) enlargement and pulmonary function in patients with chronic obstructive pulmonary disease (COPD).Methods From December 2012 to June 2016,78 patients with acute exacerbation of COPD in the Eighth People＇s Hospital of Qingdao were selected. According to pulmonary CT findings,they were divided into two groups : PA enlargement group (38 cases) was PA＞3.0cm,normal PA group(40 cases) was PA≤3.0cm.FEV1and FVC of stable phase were compared.Results The FEV1of men in the A enlargement group was (1.08 ±0.44)L,that in the normal PA group was (1.44 ±0.66)L,the difference was statistically significant (t＝2.27,P＝0.028).The FEV1of women in the PA enlargement group was (0.90 ±0.41)L,which in the normal PA group was (1.35 ±0.58)L,the difference was statistically significant (t＝2.28,P＝0.026).Correlation analysis showed that the diameter of PA was negatively related with FEV 1/FVC(r＝-0.509,P＝0.001),PA enlargement was related with lung function decline.Conclusion COPD patients with PA enlargement are more associated with accelerated loss of lung function and should be treated early.