慢性阻塞性肺疾病患者左室结构和功能改变的研究

The Changes in Structure and Function of Left Ventricular in COPD Patients

目的通过对慢性阻塞性肺疾病(COPD)患者和健康人群的心脏超声进行对比分析,了解COPD患者左室结构和功能的改变,探讨COPD对左室结构和功能的影响。方法 COPD组69例,年龄(69.0±7.8)岁;健康对照组40例,年龄(67.8±7.6)岁。应用美国PHILIPS公司产IE33彩色多普勒超声诊断仪进行心脏超声检查,测定左室舒张末期容积、左室收缩末期容积和心排出量。结果 COPD组室间隔振幅、左室舒张末期内径、左室舒张末期容积和每搏量显著小于对照组(P<0.05),心率显著快于对照组(P<0.05),两组间心排出量无显著差别(P>0.05)。对COPD组进行亚组分析显示,COPD合并肺心病组室间隔厚度和振幅均显著高于单纯COPD组(P<0.05)。结论COPD患者左室心腔变小,室间隔振幅下降,每搏量降低,心率代偿性增快,维持心排出量于相对正常水平。COPD合并肺心病者左室功能受损更为严重。

Objective To analyze the influence of COPD on the structure and function of left ventricular. Methods Sixty-nine COPD patients （mean age：69.0 ± 7.8 yrs） and forty healthy controls （ mean age ： 67. 8± 7.6 yrs） were enrolled in this study. Both groups underwent Doppler echocardiography. Heart rate （HR） were recorded. Left ventricular end-diastolic volume （LVEDV）, left ventricular end- diastolic diameter （LVEDD）, interventricular septum （IVS）, stroke volume （SV）, and cardiac output （CO） were measured. The changes of left ventricular were compared between the COPD patients and the healthy controls, and also between the COPD patients with or without chronic cor pulmonale. Results Compared with the healthy controls, movement range of IVS, LVEDD, LVEDV, and SV reduced significantly （ P 〈 0. 05）, and HR raised significantly in the COPD patients （ P 〈 0.05 ）. CO had no significant difference between two groups （P 〉 0. 05 ）. Sub-group analysis indicated that the thickness and movement range of IVS were greater in the patients with cor pulmonale secondary to COPD than those without eor pulmonale （P 〈 0.05 ）. Conclusions In COPD patients,left ventricular chamber size decreases, and left ventricular systolic function is impaired. Left ventricular function is impaired more severe in cor pulmonale secondary to COPD than COPD without cor pulmonale.