伴有/不伴有合并症的慢性阻塞性肺疾病稳定期患者病位特征及其与肺功能的相关性

Location characteristics of stable COPD patients with/without complications and their correlation with pulmonary function

目的:探讨伴有/不伴有合并症的慢性阻塞性肺疾病(COPD)稳定期患者病位特征及其与肺功能的相关性。方法:收集538例COPD患者的人口统计学、身体质量指数、吸烟指数、急性加重次数、合并症、呼吸困难程度、COPD评估测试、肺功能、中医证候等资料,进行统计学分析。结果:伴有与不伴有合并症的COPD稳定期患者中,病位涉及脾,在不同肺功能分级方面有差异,其中GOLD1(χ^2=5.779,P<0.05)、GOLD2(χ^2=10.733,P<0.01)、GOLD3(χ^2=1.372,P>0.05)、GOLD4(χ^2=0.001,P>0.05)。伴有与不伴有合并症的COPD稳定期患者中,病位涉及肾,在不同肺功能分级方面表现出类似差异。Logistic回归分析显示,在GOLD2级患者中,同时具备病位在肺肾的患者在伴有与不伴有合并症的COPD稳定期患者中有差异(OR=3.003,95%CI[1.532,5.888])。结论:合并症的存在对COPD稳定期患者的病位产生影响,伴有合并症的COPD稳定期患者在早期即可出现肺肾同病,随着气流受限的增加,病位在肺肾的比例逐渐上升。

Objective:To investigate the location characteristics of stable chronic obstructive pulmonary disease(COPD)patients with or without complications and its correlation with pulmonary function.Methods:A total of 538 cases of COPD were collected for demographic,body mass index(BMI),smoking index,number of acute exacerbation,complications,degree of dyspnea,COPD assessment test,pulmonary function,TCM syndrome and so on,and analyzed statistically.Results:In stable COPD patients with and without complications,the location of COPD was related to the spleen,and there were differences in different pulmonary function classifications,including GOLD1(χ^2=5.779,P<0.05),GOLD2(χ^2=10.733,P<0.01),GOLD3(χ^2=1.372,P>0.05),GOLD4(χ^2=0.001,P>0.05).In stable COPD patients with and without complications,the location of the disease involves the kidney,showing similar differences in different pulmonary function grades.Logistic regression showed that in GOLD2 patients,patients with both lung and kidney lesions were significantly different in stable COPD patients with and without complications(OR=3.003,95%CI[1.532,5.888]).Conclusion:The presence of complications has an impact on the location of COPD patients in stable phase.COPD patients with complications in stable phase may have both lung and kidney disease in the early stage.With the increase of airflow limitation,the proportion of lung and kidney disease location increases gradually.