慢性阻塞性肺疾病致慢性肺源性心脏病63例临床分析

Clinical analysis on 63 cases of chronic pulmonary heart disease caused by chronic obstructive pulmonary disease

目的:探讨慢性阻塞性肺疾病致慢性肺源性心脏病的治疗方法及其临床疗效。方法:2011-2014年收治慢性阻塞性肺疾病(COPD)致慢性肺源性心脏病(CPHD)患者126例,按随机数字表法将其分为对照组和观察组,各63例。对照组给予常规治疗,观察组在此基础上加用螺内酯片治疗,比较两组患者的临床疗效、治疗前后的肺功能指标、血压和心率的变化情况。结果:观察组治疗总有效率95.24%,对照组82.54%。治疗前两组患者的用力肺活量(FVC)占预计值百分比(FVC%)、1 s用力呼气末容积(FEV1)占预计值百分比(FEV1%)、FEV1/FVC、血压和心率比较差异无统计学意义(P>0.05),治疗后两组患者的FEV1%、FEV1/FVC和心率比较差异均具有统计学意义(P<0.05)。结论:在常规治疗基础上应用螺内酯治疗慢性阻塞性肺疾病致肺心病疗效确切,可改善患者的肺功能,具有临床推广价值。

Objective:To study the treatment of chronic pulmonary heart disease caused by chronic obstructive pulmonary disease and its clinical efficacy.Methods:126 patients with chronic pulmonary heart disease(CPHD) caused by chronic obstructive pulmonary disease(COPD) were selected from 2011 to 2014.They were randomly divided into the control group and the observation group with 63 cases in each according to the random number table method.The control group were given conventional treatment,while the observation group added spironolactone tablets based on the conventional treatment,then we compared the changes of clinical curative effect,the pulmonary function,blood pressure and heart rate before and after treatment between the two groups.Results:The total effective rate of the observation group was 95.24%,while the control group was 82.54%.Before the treatment,there has no significant differences in percent predicted(FVC%) of forced vital capacity(FVC) of the patients,prediction percentage(FEV1%) of forced expiratory volume 1 s(FEV1),FEV1/FVC,blood pressure and heart rate between the two groups(P>0.05);after the treatment,the FEV1%,FEV1/FVC and heart rate were statistically significant difference(P<0.05).Conclusion:Based on the conventional treatment,application of spironolactone on pulmonary heart disease induced by chronic obstructive pulmonary disease has curative effect.It can improve lung function of patients,so it is worthy of clinical application.