强直性脊柱炎全脊柱后凸角对心肺功能的影响

Effect of kyphosis in ankylosing spondylitis on cardiopulmonary function

目的探讨强直性脊柱炎(AS)患者全脊柱后凸角(GK)对心肺功能的影响.方法回顾性分析2021-10至2022-10北京大望路急诊抢救医院收治的46例AS合并脊柱后凸畸形患者的临床资料,根据全脊柱后凸角大小,分为重度组23例(GK角>95°),中度组23例(80°≤GK角≤95°).采用Pearson统计学相关性分析GK角对两组肺功能指标、心脏基本结构及功能参数的影响.结果随着GK角增大,房室腔内径[左房内径(LAD)、舒张末期左室内径(LVDD)、收缩末期左室内径(LVSD)、右房内径(RAD)、右室内径(RVD)]、舒张早期最大峰值速度与舒张晚期最大峰值速度比值(E/A)及二尖瓣间隔瓣环舒张早期速度与舒张晚期速度比值(e'/a')逐渐减小,而E/e'逐渐增大,组间比较差异有统计学意义(P<0.05).纳入患者肺功能结果显示,重度组与中度组比较,限制性通气功能、小气道功能及换气功能参数均存在不同程度降低(P<0.05).随着GK角增加,左房室腔大小(LAD、LVDD、LVSD)及舒张功能参数(E/A、e'/a')逐渐减小,呈显著负相关性(P<0.05);并且GK角与肺限制性通气功能参数呈显著负相关性(P<0.05).结论AS患者GK角对心肺功能存在一定影响.GK角越大,心脏房室腔内径越小,左室舒张功能越差.同时结果显示GK角越大,患者相应肺功能越差.

Objective To analyze the characteristics of cardiopulmonary function in patients with ankylosing spondylitis(AS),and explore the influence of global kyphosis(GK)on cardiopulmonary function.Methods Retrospective analysis of the clinical data of 46 patients with AS complicated with kyphosis admitted to Beijing Dawang Lu Emergency Hospital from October 2021 to October 2022.According to the to global kyphosis Angle,they were divided into severe group(GK>95°),23 cases in the moderate group(80°≤GK≤95°).Statistical correlations of Pearson or Spearman were used to analyze the effect of GK angle on lung function indexes,and basic cardiac structure and functional parameters in both groups.Results As the GK angle increases,the diameter of the atrioventricular cavity(left atrial diameter,left ventricular diameter in end diastole,left ventricular diameter in end systole,right atrial diameter,right ventricular diameter),the ratio of early diastolic peak velocity to late diastolic peak velocity(E/A),and the ratio of early diastolic velocity to late diastolic velocity(e’/a’)of the mitral septal ring gradually decrease,while E/e’gradually increases,There was a significant statistical difference between groups(P<0.05).The pulmonary function results of the included patients showed:Compared with the moderate group,the severe group had varying degrees of decreased restrictive ventilation function,small airway function and gas exchange function parameters(P<0.05).Correlation analysis showed that,as the GK Angle increases,the left atrioventricular cavity size(LAD,LVDD,LVSD)and diastolic function parameters(E/A,e’/a’)gradually decreased,showing a significant negative correlation(P<0.05);There was a significant negative correlation between GK angle and parameters of pulmonary restrictive ventilation function(P<0.05).Conclusions GK angle of AS patients has certain influence on cardiopulmonary function.The larger the GK angle is,the smaller the atrioventricular cavity diameter is,and the worse the left ventricular diastolic function is.At the same time,the results showed that the larger the GK angle was,the worse the corresponding pulmonary function of patients was.