超声心动图联合BODE指数在慢性阻塞性肺疾病患者病情严重程度评估中的价值分析

Value of echocardiography combined with BODE index in assessing disease severity in chronic obstructive pulmonary diseases patients

目的 分析超声心动图联合BODE指数评估慢性阻塞性肺疾病(COPD)患者病情严重程度的价值。方法 选取2019年4月12日至2020年4月12日商丘市第一人民医院所收治89例COPD患者的临床资料进行回顾性分析。根据患者病情严重程度分为2组,病情处于稳定期的患者共54例设为观察A组,病情处于急性加重期的患者共35例设为观察B组。另取同期来我院体检(均接受超声心动图检查)的健康者的资料进行分析,共42名。分析3组研究对象的超声心动图及2组COPD患者BODE指数。结果 观察B组的右心房面积、右心室面积、右心房上下径、右心房左右径、右心室基底段内径大于观察A组和对照组(P<0.05)。观察A组的右心房面积、右心室面积、右心房上下径、右心房左右径、右心室基底段内径大于对照组(P<0.05)。观察B组的三尖瓣环平面收缩漂移(TAPSE)、三尖瓣口舒张早期血流速度/三尖瓣口舒张晚期血流速度(E/A)小于观察A组和对照组右心室侧壁基底段的纵向应变(RV-strain),右心室心肌做功指数(RV-MPI)和下腔静脉深吸气塌陷指数(CI)大于观察A组和对照组(P<0.05)。观察B组的TAPSE、E/A显著小于对照组,RV-strain、RV-MPI和CI大于对照组(P<0.05)。受试者工作特征(ROC)曲线下面积分析可知,超声心动图+BODE指数联合检测显著优于二者单独检测(P<0.05)。结论 超声心动图与BODE指数均能有效评估COPD患者病情严重程度,二者联合检测在COPD诊断中具有较好的价值。

Objective To investigate the value of echocardiography combined with BODE index in assessing the disease severity in chronic obstructive pulmonary diseases(COPD) patients. Methods Clinical data from 89 COPD patients admitted to our hospital between April 12,2019 and April 12,2020 were reviewed.According to their disease severity, the patients were divided into two groups. The study group A included patients with stable COPD(n=54),while the study group B included patients with acute exacerbation of COPD(n=35). In addition,we included a contemporary cohort of health checkup subjects as control group(n=42,all underwent echocardiography). The echocardiography of the three groups of subjects and the BODE index of COPD patients in the two study groups were analyzed. Results The right atrial(RA)area,right ventricular(RV)area,RA superior-inferior diameter,RA left-right diameter,and RV basal diameter were significantly greater in the study group B than those in the study group A and control group(P <0.05). The RA area,RV area,RA superior-inferior diameter,RA left-right diameter,and RV basal diameter were significantly greater in the study group A than those in the control group(P <0.05). Compared with the study group A and control group, the study group B showed significantly lower tricuspid annular plane systolic excursion(TAPSE) and E/A ratio, as well as significantly greater RV strain, RV myocardial performance index(MPI) and cardiac index(CI)(P<0.05). Compared with the control group,the study group B showed significantly lower TAPSE and E/A ratio,as well as significantly greater RV strain,RV MPI and CI(P<0.05). Analysis of the area under the receiver operating characteristic(ROC) curve showed that echocardiography combined with BODE index was significantly more helpful than either used alone(P<0.05). Conclusion Either echocardiography or BODE index can effectively assess the disease severity in COPD patients. Combination of the two can be more valuable in diagnosing COPD.