慢性阻塞性肺疾病患者并发心血管疾病危险因素及预测模型建立

Risk factors for cardiovascular disease in patients with chronic obstructive pulmonary disease and prediction model established

目的:探究慢性阻塞性肺疾病(COPD)患者并发心血管疾病的危险因素,并根据差异性指标建立预测模型。方法:回顾性分析216例COPD患者的临床资料,根据患者是否并发心血管疾病分为发生组(n=98)与未发生组(n=118)。记录并比较两组患者一般资料、肺功能、血清炎性指标、血脂水平及血气分析指标;采用Logistics回归分析影响患者心血管疾病的相关因素,并采用受试者工作曲线(ROC)检验各差异性指标对并发心血管疾病的预测价值。结果:两组患者年龄、体质量指数(BMI)、是否患有高血压及是否饮酒等方面占比比较,差异具有统计学意义(P<0.05)。发生组MMEF%pred、FEV1、LDL-C及PaO_(2)水平均低于未发生组,hs-CRP、IL-6、TNF-α及TG水平均高于未发生组(P<0.05)。Logistics分析结果显示,FEV1偏低、hs-CRP偏高、IL-6偏高、LDL-C偏低、TG偏高、PaO_(2)偏低、年龄偏高、患有高血压及饮酒均为影响患者并发心血管疾病的相关因素,构建预测模型:Z=-0.212×FEV1+0.270×hs-CRP+0.203×IL-6-1.790×LDL-C+1.914×TG-0.134×PaO_(2)+1.430×年龄+1.795×是否患有高血压+1.122×是否饮酒+2.768。经ROC曲线分析得知,预测模型曲线下面积(AUC)=0.940,敏感度为0.878,特异度为0.873。结论:FEV1偏低、hs-CRP偏高、IL-6偏高、LDL-C偏低、TG偏高、PaO_(2)偏低、年龄偏高、患有高血压及饮酒均可增加COPD患者并发心血管疾病风险,且该类指标可提示患者并发心血管疾病的风险程度,具备较高的预测价值。

Objective:To explore the risk factors of cardiovascular disease in patients with chronic obstructive pulmonary disease,and establish prediction models based on differential indicators.Methods:The clinical data of 216 patients with COPD were retrospectively analyzed,and the patients were divided into the occurrence group(n=98)and the non-occurrence group(n=118)according to whether the patients were complicated by cardiovascular disease.The general data,lung function,serum inflammatory indexes,blood lipid levels and blood gas analysis indexes of the two groups were recorded and compared.Logistics regression was used to analyze the relevant factors affecting cardiovascular disease in patients,and the subject s work curve(ROC)was used to test the predictive value of cardiovascular disease complicated by each differentiating index.Results:The proportion of patients in the two groups was different in terms of age,body mass index(BMI),whether they had hypertension and whether they drank alcohol(P<0.05).The levels of MMEF%pred,FEV1,LDL-C and PaO_(2) in the occurrence group were lower than those in the non-occurrence group,and the levels of hs-CRP,IL-6,TNF-αand TG were higher than those in the non-occurrence group(P<0.05).The results of Logistics analysis showed that low FEV1,high hs-CRP,high IL-6,low LDL-C,high TG,low PaO_(2),high age,hypertension and alcohol consumption were all relevant factors affecting patients with cardiovascular disease,predictive models were constructed:Z=-0.212×FEV1+0.270×hs-CRP+0.203×IL-6-1.790×LDL-C+1.914×TG-0.134×PaO_(2)+1.430×age+1.795×whether you have hypertension+1.122×whether you drink alcohol+2.768.The ROC curve analysis showed that the area under the curve(AUC)=0.940,the sensitivity was 0.878,and the specificity was 0.873.Conclusion:Low FEV1,high hs-CRP,high IL-6,low LDL-C,high TG,low PaO_(2),high age,hypertension and alcohol consumption can increase the risk of cardiovascular disease in patients with chronic obstructive pulmonary disease,and these indicators can indicate the risk of cardiovascular disease and have high predictive value.