慢性阻塞性肺疾病伴高血压病的临床特征和危险因素分析

Analysis of clinical manifestation and risk factors of chronic obstructive pulmonary disease with hypertension

目的评估未治疗的初诊慢性阻塞性肺疾病(COPD)伴高血压病患者的患病率、临床特征及危险因素。方法采用横断面人群筛查方法抽样受试者,最终纳入初诊COPD患者569例,并分为COPD伴高血压病组249例,COPD不伴高血压病组320例。观察2组呼吸道症状、生活质量评分、血液指标;分析初诊COPD伴高血压病的高危因素。结果COPD伴高血压病组平均年龄、男性占比、身体质量指数(BMI)、吸烟指数高于COPD不伴高血压病组,差异有统计学意义(P<0.05)。COPD伴高血压病组合并糖尿病和心血管疾病比率均高于COPD不伴高血压病组,差异有统计学意义(P<0.05)。COPD伴高血压病组改良呼吸困难指数(mMRC)和慢性阻塞性肺疾病评估测试(CAT)评分均高于COPD不伴高血压病组,差异有统计学意义(P<0.05)。COPD伴高血压病组白细胞总数、中性粒细胞计数、嗜酸性粒细胞计数、单核细胞计数均高于COPD不伴高血压病组,差异有统计学意义(P<0.05)。COPD伴高血压病组静脉空腹血糖、甘油三酯、尿酸、血肌酐水平均高于COPD不伴高血压病组,高密度脂蛋白胆固醇水平低于COPD不伴高血压病组,差异有统计学意义(P<0.05)。高龄、肥胖、空腹血糖升高、单核细胞绝对值升高是COPD伴高血压病的独立危险因素。结论高龄、肥胖、单核细胞计数增高、高血糖的COPD患者更容易合并高血压病,其生活质量较差。全面评估监测COPD患者的代谢状况,控制危险因素,减少合并症的发生具有重要意义。

Objective To evaluate the prevalence,clinical characteristics,and risk factors of untreated patients with newly diagnosed chronic obstructive pulmonary disease(COPD)with hypertension.Methods A total of 569 newly diagnosed COPD patients were selected by cross-sectional population screening,and divided into COPD patients with hypertension group(n=249)and COPD patients without hypertension group(n=320).Respiratory symptoms,quality of life score and blood indexes were observed in the two groups;high risk factors of newly diagnosed COPD with hypertension were analyzed.Results The mean age,male ratio,body mass index(BMI)and smoking index in the COPD with hypertension group were significantly higher than those in the COPD without hypertension group(P<0.05).The rates of diabetes and cardiovascular disease in the COPD with hypertension group were significantly higher than those in the COPD without hypertension group(P<0.05).The score of modified medical research council(mMRC)and COPD assessment test(CAT)in the COPD with hypertension group were significantly higher than those in the COPD without hypertension group(P<0.05). The total white blood cell count,neutrophils count,eosinophils count and monocytes count in the COPD with hypertension group were significantly higher than those in the COPD without hypertension group(P<0.05).The levels of venous fasting blood glucose,triglyceride,uric acid and serum creatinine in the COPD with hypertension group were significantly higher,and the levels of high-density lipoprotein cholesterol were significantly lower than those in the COPD without hypertension group(P<0.05).Older age,obesity,elevated fasting blood glucose and absolute monocyte value are independent risk factors for COPD with hypertension.Conclusion COPD patients with increasing age,obesity,increased monocyte count,and hyperglycemia are more likely to be accompanied by hypertension,and their quality of life is poor.It is of great significance to comprehensively evaluate and monitor the metabolic status of COPD patients,control risk factors and reduce the incidence of complications.