小气道功能与老年冠心病的相关性

Correlation between small airway function and elderly coronary heart disease

目的探讨小气道功能与老年冠心病的相关性。方法选取2020年1月至2021年6月浙江医院收治的冠心病患者180例(观察组)和体检健康者180例(对照组),收集所有研究对象肺通气功能检查和实验室检查等相关临床资料。先采用t检验或秩和检验或χ^(2)检验比较两组患者的基线资料和肺通气功能指标,然后将有统计学意义的指标纳入logistic回归模型进行多因素分析。结果与对照组比较,观察组有高血压史的比例更高,白细胞计数、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、超敏C反应蛋白、总胆固醇水平更高(χ^(2)=28.477,Z=3.673、6.573、6.782、2.086,t=9.538;P<0.05或0.01);用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC、最大呼气中段流量(MMEF)、用力呼气50%肺活量的瞬时流速及用力呼气75%肺活量的瞬时流速(FEF75)均明显降低(t=-5.244、-6.647、-3.247、-6.060、-5.636、-3.477,P<0.01),小气道障碍发生率明显增高(χ^(2)=19.897,P<0.01)。Logistic回归分析结果显示,反映小气道功能的MMEF、FEF75与老年冠心病明显相关(OR=0.950、1.021,95%CI=0.911-0.990、1.003-1.040,P<0.05)。结论小气道功能障碍可能参与并促进了老年冠心病的发生。

Objective To investigate the correlation between small airway function and coronary heart disease(CHD)in the elderly patients.Methods A total of 180 patients with CHD confirmed by coronary angiography in Zhejiang Hospital from January 2020 to June 2021 were selected as the observation group,and 180 healthy controls who underwent physical examination during the same period were selected as the control group.Collected the relevant clinical data such as pulmonary ventilation function examination and laboratory examination of all subjects.T test/rank-sum test/Chi-square test were used for comparing the baseline data and pulmonary ventilation function indexes between the two groups,and then the statistically significant indexes were incorporated into the logistic regression model for multivariate analysis.Results Compared with the control group,the observation group had a higher proportion of history of hypertension,white blood cell count,high density lipoprotein cholesterol,low density lipoprotein cholesterol,hypersensitive C reactive protein and total cholesterol(χ^(2)=28.477;Z=3.673,6.573,6.782,2.086;t=9.538;P<0.05 or P<0.01).Forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),FEV1/FVC,maximum mid-expiratory flow maximal midexpiratory flow(MMEF),forced expired flow at 50%of FVC and forced expired flow at 75%of FVC(FEF75),in observation group were lower than those in control group(t=-5.244,-6.647,-3.247,-6.060,-5.636,-3.477,P<0.01),and the proportion of small airway obstruction was higher than that in control group (χ^(2)=19.897, P < 0.01). The results of Logistic regression analysis showed that MMEF and FEF75 were significantly correlated with CHD in the elderly (OR=0.950, 1.021;95%CI=0.911-0.990, 1.003-1.040;P < 0.05). Conclusion The decline of small airway function may contribute to the occurrence of CHD in the elderly.