|
|
|
| Changes of right ventricular function and prognosis evaluation in elderly patients with acute exacerbation of chronic obstructive pulmonary diseases and acute myocardial infarction |
| ZHANG Chenchen1 SONG Shuangshuang1 LIU Linglin1 YU Juanchun2 XIONG Wei1 |
1.Department of Geriatric, Southwest Hospital, Army Medical University, Chongqing 400038, China;
2.Department of Clinical Laboratory, Xinqiao Hospital, Army Medical University, Chongqing 400038, China |
|
|
|
Abstract Objective To investigate the changes of right ventricular function and prognosis evaluation in elderly patients with acute exacerbation of chronic obstructive pulmonary diseases (COPD) and acute myocardial infarction (AMI). Methods From October 2015 to August 2017, in Department of Geriatric, Southwest Hospital, Army Medical University, 30 elderly patients with acute exacerbation of COPD (AECOPD) and AMI patients were selected as the observation group, 30 cases of AMI elderly patients without AECOPD were selected as the control group, heart function index and right heart structure index of two groups were respectively tested by echocardiography, blood gas analysis and detection of myocardial injury markers, morbidity and mortality rate of complications were recorded. Results The PaO2 level of the observation group was significantly lower than the control group (P < 0.01), PaCO2, CK-MB cTnT and pro-BNP were significantly higher than the control group (P < 0.01); LVEF of the observation group was significantly lower than the control group (P < 0.01), the relevant indicators of the right ventricular function (RVEDV, RVESV and RVSV) of the patients in the observation group were significantly higher than the control group (P < 0.01), and RVEF was significantly lower than the control group (P < 0.01); PAD, RVED, RVAWT and Tei index of the observation group were significantly higher than the control group (P < 0.01); the electrolyte disorders, pulmonary infection, the incidence of heart failure, cardiogenic shock and respiratory failure of the observation group were significantly higher than the control group (P < 0.05), and there was no significantly difference in the mortality between the two groups (P > 0.05). Conclusion AECOPD with AMI can lead to ventricular remodeling and cardiac hypertrophy early, which can further lead to further deterioration of cardiac function in AMI patients, and seriously affect the short-term prognosis.
|
|
|
|
|
|
[1] 吴昕，黄翔，吴华容，等.慢性阻塞性肺疾病与动脉粥样硬化的相关性分析[J].内科急危重症杂志，2016，22（6）：452-453，463.
[2] Cung TT，Morel O，Cayla G，et al. Cyclosporine before PCI in patients with acute myocardial infarction [J]. N Engl J Med，2015，373（11）：1021-1031.
[3] 宋祝，王蒙，徐昕烨，等.COPD与冠脉病变严重程度的相关性分析[J].国际呼吸杂志，2017，37（12）：921-925.
[4] Clark TW，Medina MJ，Batham S，et al. C-reactive protein level and microbial aetiology in patients hospitalised with acute exacerbation of COPD [J]. Eur Respir J，2015，45（1）：76-86.
[5] 中华医学会心血管病学分会，中华心血管病杂志编辑委员会.不稳定性心绞痛与非ST段抬高心肌梗死诊断和治疗指南[J].中华心血管病杂志，2007，35（4）：295-304.
[6] 金哲，王广发.慢性阻塞性肺疾病全球倡议（2014更新版）解读[J].中国医学前沿杂志：电子版，2014，6（2）：94-97.
[7] 何斌，周敏.慢性阻塞性肺疾病表型与急性加重相关性的研究进展[J].国际呼吸杂志，2016，36（19）：1498-1503.
[8] 王秋月.慢性阻塞性肺疾病急性加重的诊治进展[J].中国实用内科杂志，2007，27（16）：1243-1246.
[9] 黄昌成，何建华.慢性阻塞性肺疾病与冠状动脉粥样硬化相关性研究[J].西部医学，2015，27（1）：69-71.
[10] Dursunoglu N，Dursunoglu D，YιldΙz AÌ，et al. Severity of coronary atherosclerosis in patients with COPD [J]. Clin Respir J，2017，11（6）：751-756.
[11] 刘正会，李丽.炎症因子的变化在慢性阻塞性肺疾病病程发展中的应用探讨[J].临床肺科杂志，2013，18（9）：1565-1567.
[12] 何玉，张健，秦明照，等.慢性阻塞性肺病的全身炎症反应对心血管疾病的影响[J].中国医刊，2015，50（1）：32-35.
[13] Mooe T，Stenfors N. The prevalence of COPD in individuals with acute coronary syndrome：a spirometry-based screening study [J]. Int J Chron Obstruct Pulmon Dis，2015， 12（4）：453-461.
[14] 齐浩明，王忠，王丽，等.慢性阻塞性肺疾病对冠心病患者心功能的影响[J].海南医学，2013，24（6）：795-797.
[15] 杨鑫玲.老年慢性阻塞性肺病并发冠状动脉粥样硬化性心脏病的相关因素[J].中国医药导报，2015，12（3）：88-90，99.
[16] 钱凤文，陈利明.超声心动图新技术在评价肺动脉高压患者右心功能中的应用进展[J].中国呼吸与危重监护杂志，2013，12（4）：427-429.
[17] 杜佩.肺动脉高压患者右室功能的多普勒超声评价与进展[J].心血管病学进展，2014，35（4）：476-479.
[18] 雷应军，胡振红，刘海潮.无创正压通气对COPD合并肺源性心脏病急性加重期患者疗效和血气、炎性指标的影响[J].疑难病杂志，2016，15（3）：233-235.
[19] 肖伟峰，苗虎，范元，等.不同剂量N-乙酰半胱氨酸对不同病期慢性阻塞性肺疾病患者氧化应激及炎性反应介质和免疫功能的影响[J].中国医药科学，2017，7（13）：17-21.
[20] 梅牧，罗红.慢性阻塞性肺疾病患者颈动脉内膜受损的临床观察[J].中国现代医生，2017，55（29）：43-46.
[21] 罗燕珊.比索洛尔联合曲美他嗪治疗冠心病合并慢性阻塞性肺疾病心力衰竭的临床效果[J].中国当代医药，2016，23（26）：115-117.
[22] 赵平.比索洛尔治疗冠心病伴COPD的疗效及对肺功能的影响[J].现代中西医结合杂志，2013，22（7）：727-728. |
|
|
|
