慢性阻塞性肺疾病合并心衰的临床分析

Clinical analysis of chronic obstructive pulmonary disease with heart failure

目的分析慢性阻塞性肺疾病(COPD)合并心力衰竭(心衰)的临床特征,观察β受体阻断剂治疗对COPD患者心、肺功能的影响。方法回顾性分析2011年10月-2015年4月于医院就诊的COPD合并心衰患者52例的临床资料,根据患者是否服用β受体阻滞剂,将患者分为服用组22例与未服用组30例。观察治疗后2组患者的肺功能及心功能。结果 52例患者中,合并扩心病及冠心病各4例(7.7%);高血压11例(21.2%);糖尿病5例(9.6%);风心病2例(3.8%);COPD合并慢性肺心病21例(40.4%)。2组患者肺功能比较差异无统计学意义(P>0.05)。服用组BNP、LVEF、6 min步行距离、LVEDD、LVESD、HR均优于未服用组,差异均有统计学意义(P<0.05)。结论高龄COPD患者并发症较多,易发生心衰且不易诊断,因此,对COPD患者要提高心衰的诊断率,以提高治愈率,β受体阻断剂使用者心功能指标优于未使用者。

Objective To analyze the clinical features of chronic obstructive pulmonary disease（ COPD） complicated with heart failure in the hospital,and to explore the effect on the heart and lung function of β blockers in the treatment of these patients. Methods Retrospectively analyzed the clinical data of 52 COPD patients who came to the hospital from October 2011 to April 2015. Patients were divided into treated group 22 cases and untreated group 30 cases depending on whether the patient took β blocker. The lung function and cardiac function of two groups were observed. Results Among 52 patients,combined with heart disease and coronary heart disease each for 4 cases,accounting for 7. 7%; 11 cases of hypertension,accounting for21. 2%; 5 cases of diabetes,accounting for 9. 6%; 2 cases of rheumatic heart disease,accounting for 3. 8%; 21 cases of COPD with chronic pulmonary heart disease,accounting for 40. 4%. There was no significant difference in lung function between two groups（ P 〉0. 05）. The BNP,LVEF,6 min walking distance,LVEDD,LVESD and HR of treated group were all better than untreated group,and the differences were statistically significant（ P〈 0. 05）. Conclusion Elderly COPD patients are often accompanied by more complications,prone to heart failure and difficult to diagnose. Therefore,the diagnosis rate of heart failure should be increased for patients with COPD in order to increase the cure rate. β blocker users have better cardiac performance than non-users.