老年高血压伴慢性阻塞性肺疾病的临床分析及干预对策

Clinical Analysis of Elderly Hypertensive Patients with Chronic Obstructive Pulmonary Disease and the Intervention Strategy

目的探讨老年高血压伴慢性阻塞性肺疾病(COPD)的临床情况,并采取相对应的措施进行治疗,以期提高临床治疗水平。方法回顾性分析2010年1月至2013年1月北京市延庆县中医医院收治的70例老年高血压伴COPD患者的临床资料,将其设为老年高血压伴COPD组,另外选取同期该院70例老年高血压不伴COPD患者设为老年高血压非COPD组,比较两组患者的临床症状、体征,高血压不伴COPD予以常规降压治疗,高血压伴COPD在降压治疗基础上加用化痰、改善呼吸功能等对症治疗,比较两组治疗后的临床效果。结果老年高血压伴COPD临床表现以肺部症状为主,体征以肺部湿啰音为主。在临床效果上,老年高血压非COPD组显效27例(38.57%),总有效率为81.43%;老年高血压伴COPD组显效41例(58.57%),总有效率为91.86%。治疗前两组患者在白细胞介素(IL)1、干扰素α、IL-8、IL-10、动脉血氧分压(PaO2),二氧化碳分压(PaCO2)、收缩压、舒张压的比较,差异无统计学意义(P>0.05);而老年高血压伴COPD组与老年高血压非COPD组治疗后在IL-1、干扰素α、IL-8、IL-10、PaO2、PaCO2、收缩压、舒张压的比较差异有统计学意义(P<0.05)。结论老年高血压伴COPD临床症状典型,在治疗上要随症运用。

ObjectiveTo discuss the clinical situation of elderly hypertensive patients with chronic obstructive pulmonary disease（COPD） and take corresponding treatments in order to improve the therapeutic level.MethodsA retrospective analysis on the clinical data of 70 cases of elderly hypertensive patients with COPD from Jan.2010 to Jan.2013 from Yanqing County Chinese Medicine Hospital was done,which were set as elderly hypertensive COPD group,another 70 cases of elderly hyertensive without COPD were selected and set as elderly hypertensive non-COPD group,the clinical symptoms,signs,hypertension is not associated with COPD to be conventional antihypertensive treatment of the two groups were compared,hypertension non-COPD group was given conventional hypotensive treatment,while hypertensive COPD group was also given expectorantand respiratory function improvement treatment,and the clinical outcomes of the two groups were compared.ResultsIn elderly hypertensive patients with COPD,clinical manifestations are mainly pulmonary symptoms,and pulmonary auscultation is the main symptom.As for clinical effects,in elderly hypertensive non-COPD group,effective number was 27 cases（38.57%）,total effective rate was 81.43%;the effective cases in elderly hypertensive patients with COPD group was 41（58.57%）,total effective rate was 91.86%.Interleukin （IL）1,interferon-α,IL-8,IL-10,arterial oxygen pressure （PaO2）,carbon dioxide partial pressure（PaCO2）,systolic blood pressure,and diastolic blood pressure of the two groups before treatment had no statistically significant difference（P〉0.05）;while after treatment the IL-1,INF-α,IL-8,IL-10,PaO2,PaCO2,systolic blood pressure,diastolic blood pressure were statistically significant different（P〈0.05） between the two groups.ConclusionClinical symptoms of elderly hypertensive patients with COPD are typical,and the treatment should be adjusted according to the symptoms in clinical.