慢性阻塞性肺疾病患者自主神经功能的相关影响因素分析

Analysis of related influencing factors of autonomic nervous function in patients with chronic obstructive pulmonary disease

目的探究影响慢性阻塞性肺疾病(COPD)患者自主神经功能的相关因素。方法将120例COPD患者归为COPD组,按严重程度分为轻度组(n=35)、中度组(n=48)和重度组(n=37),匹配50例健康人群为对照组。比较各组间肺功能和心率变异性(HRV)指标,分析HRV与肺功能的相关性。结果COPD组用力肺活量(FVC)、第1秒用力肺活量(FEV 1)、FEV 1/FVC、最大呼气流速(PEF)、气道阻力(R)均低于对照组(P均<0.05)。随着病情的加重,轻度组、中度组和重度组的FVC、FEV 1、FEV 1/FVC、PEF和R逐渐降低,差异均具有统计学意义(P均<0.05)。COPD组的HRV指标均低于对照组(P均<0.05),且随着病情加重,轻度组、中度组和重度组的HRV指标逐渐降低,差异均具有统计学意义(P均<0.05)。HRV指标与FVC、FEV 1、FEV 1/FVC、PEF呈正相关,与R呈负相关。结论COPD患者病情越严重,自主神经功能降低越明显,且自主神经功能与肺功能密切相关。

Objective It is to investigate the related factors affecting autonomic nervous function in patients with chronic obstructive pulmonary disease(COPD).Methods 120 patients with COPD were classified as COPD group.According to their severity,they were divided into mild group(n=35),moderate group(n=48)and severe group(n=37).50 healthy people were matched as control group.The lung function and heart rate variability(HRV)indicators were compared among the groups,and the correlation between HRV and lung function was analyzed.Results The forced vital capacity(FVC),forced vital capacity(FEV 1),FEV 1/FVC,maximum expiratory flow rate(PEF)and airway resistance(R)in the COPD group were all lower than those in the control group(P<0.05).The FVC,FEV 1,FEV 1/FVC,PEF and R values of the mild,moderate and severe groups gradually decreased with the severity of the disease getting worse,and the differences between the groups were statistically significant(P<0.05).The HRV indexes of the COPD group was lower than that of the control group(P<0.05),and the HRV indexes of the mild group,the moderate group and the severe group gradually decreased with the severity of the disease getting worse,and the differences between the groups were statistically significant(P<0.05).The HRV index was positively correlated with FVC,FEV 1,FEV 1/FVC,and PEF,and negatively correlated with R.Conclusion The more severe the condition of COPD patients,the more obvious the autonomic nerve function is reduced,and the autonomic nerve function is closely related to lung function.