摘要
目的探讨慢性阻塞性肺疾病（COPD）患者气流阻塞程度与左心功能的关系。方法对36例年龄40-80岁的COPD患者进行肺功能测定，肺功能严重度分级根据GOLD标准，将这些患者按照GOLDI、Ⅱ级，GOLDIII、Ⅳ级分为2组，同时用超声心动图对这些患者的左心室功能即舒张早期血流速度峰值／舒张晚期血流速度峰值（E／A）、E峰减速时间（EDT）、缩短分数（FS％）、左心室射血分数（LVEF％）、左心室舒张末内径（LVEDD）进行测定，并与18例年龄40～70岁肺功能正常的人的左心室功能及结构进行比较。结果①GOLDI、Ⅱ级患者的E／A值与正常对照组相比显著降低，差异有统计学意义（P〈0．05）；EDT相比显著延长，差异有统计学意义（P〈0．05）；LVEF％、FS％及LVEDD相比差异无统计学意义（P〉0．05）。②GOLDⅢ、Ⅳ级患者的E／A值与正常对照组及GOLDI、II级患者相比显著降低，差异有统计学意义，分别为P〈O．01和P〈0．05；EDT相比显著延长，差异有统计学意义，分别为Pd0．01和Pd0．05；LVEF％、FS％、LVEDD相比差异无统计学意义，（P值均〉0．05）。③三组E／A值与FEV1％pred之间呈显著相关关系（r=0．479，Pd0．001），且呈正相关。结论气流阻塞可以引起左心室舒张功能下降，且E／A比值与FEV1％pred之间呈正相关，即气流阻塞程度越重，左心室舒张功能下降越大。气流阻塞程度的加重对LVEF％无影响。
Objective To investigate the relationship between degree of airflow obstruction and left ventricular function in patients with chronic obstructive pulmonary disease （COPD）. Methods Measured pulmonary function in 36 COPD persons who were 40 to 80 years of age. Lung function severity graded according to GOLD criteria,these patients were divided into 2 groups according to GOLD I , II ,GOLDIII , IV, at the same time measured left ventricular function, that is the ratio of early mitral peak flow to atrial mitral peak flow （E/A）, E deceleration time （ EDT）, Fractional shortening （FS%）, left ventricular ejection fraction （LVEF%）, left ventricular end diastolic diameter （LVEDD） by echocardiography in these patients. And compared with the left ventricular function and structure of 18 people with normal lung function. Results （1） GOLD I , II patients E/A value were significantly lower than normal control group, the difference was statistically significant （P 〈0.05）, EDT was significantly prolonged, the difference was statistically significant （ P〈0.05）, LVEF %, FS%, LVEDD were no significant difference compared （ P 〉0.05）. （2）GOLDIII, IVpatients E/A value compared with normal control group and the GOLD I , II patients were significantly lower, the difference was statistically significant,respectively P 〈0.01 and P 〈0.05, EDT were significantly prolonged, the difference was statistically significant, respectively P 〈 0.01 and P 〈 0.05, LVEF%, FS%, LVEDD were compared with no significant difference （ P 〈0.05）. （3）E/A ratio and FEV1 %pred showed a significant correlation between the three groups （ r = 0. 479, P 〈 0. 001）, and were positively correlated. Conclusions Airflow obstruction can cause left ventricular diastolic dysfunction,and E/A ratio and FEV1 ~ pred was positively correlated, that is, the more severe airflow obstruction, the greater the left ventricular diastolic dysfunction. The severity of airflow obstruction had no effect on left ventricular ejection fraction.
出处
《国际呼吸杂志》
2012年第17期1286-1289,共4页
International Journal of Respiration
关键词
慢性阻塞性肺疾病
气流阻塞程度
左心功能
Chronic obstructive pulmonary disease
Degree of airflow obstruction
Left ventricular function
