高海拔地区慢性阻塞性肺疾病不同分期合并症的临床分析

Clinical analysis of complications of different stages of COPD in high altitude areas

目的:分析青海省高海拔地区慢性阻塞性肺疾病(COPD)患者不同分期发生合并症的临床分布,对预防高海拔地区COPD合并症的发生发展以及对COPD患者的管理提供参考。方法:收集2016年1月至2019年9月在青海省某三甲综合医院3264例COPD住院患者临床资料,男性2128例,女性1136例,回顾性分析COPD患者不同分期合并症的临床分布。结果:3264例COPD患者,出现合并症的患者3204例,其中除结核外肺部感染2345例,高血压1279例,代谢紊乱综合征964例,糖尿病443例以及结核感染406例。除高血压、肺部其他疾病、糖尿病及代谢紊乱综合征外,其他在COPD不同分期之间存在统计学差异(P<0.05)。结论:大部分COPD患者均有合并症,且大于60%的患者合并四种及以上;另外,在COPD急性加重期合并肺部感染(包括结核)、心血管系统疾病、继发性红细胞增多症和低蛋白血症的发生率比COPD稳定期高。减少患者多种合并症的发生,有针对性地对其进行综合管理,对提高其生活质量具有一定的临床意义。

Objective:To study the clinical distribution different stages of COPD patients with complications,which would provide reference and basis for prevention,occurrence and development of COPD complications and the management of COPD patients in high altitude areas of Qinghai.Methods:The clinical data of 3264 patients with COPD in a tertiary general hospital in Qinghai from January 2016 to September 2019 were collected,and the clinical distribution of complications in different stages of COPD patients was analyzed retrospectively.The subjects were 2128 males and 1136 females.Results:There were 3264 COPD patients and 3204 patients with comorbidities,including 2345 lung infections other than tuberculosis,1279 hypertension,964 metabolic syndrome,443 diabetes and 406 tuberculosis infection.Besides hypertension,other lung diseases,diabetes and metabolic disorder syndrome,there are statistical differences between different stages of COPD.Conclusion:Most patients have complications,and more than 60%of patients have four or more kinds of complications.The incidence of pulmonary infection(including tuberculosis),cardiovascular diseases,secondary polycythemia and hypoproteinemia in acute exacerbation of COPD is higher than that in stable COPD.Therefore,the distribution of complications in COPD patients is clearly defined,reduce the occurrence of various complications of patients,and to carry out targeted comprehensive management on it has certain clinical significance for improving the quality of life.