摘要： 目的 探讨慢性阻塞性肺疾病急性加重（AECOPD）患者肺动脉直径与主动脉直径比值（PA/A）的临床意义及其与住院风险的相关性。方法 回顾分析2014年10月至2019年10月中国医科大学附属盛京医院呼吸与重症监护病房223例AECOPD患者的临床资料，根据胸部CT测量计算PA/A，采用t检验或χ²检验对PA/A≤1组和PA/A>1组患者临床指标进行比较。根据患者住院次数分为入院前1年内1次组和入院前1年内≥2次组，采用t检验或χ²检验比较2组临床指标的差异，对有统计学意义（P<0.05）指标进行logistic回归分析。结果 与PA/A≤1组比较，PA/A>1组吸烟史、住院时间增长，体质量指数、PaCO₂、HCO₃^-增高，入院前1年急性加重住院次数增多，而肺功能更差，有创机械通气治疗更多，差异均有统计学意义（均P<0.05）。与入院前1年内1次组比较，入院前1年内≥2次组患者FEV1%、FVC%、FEV1/FVC、HCO₃^-、肺动脉直径、住院时间、PA/A>1比例均增加（均P<0.05）。Logistic回归分析显示PA/A>1是入院前1年内≥2次住院的独立危险因素（OR=6.150；95% CI：1.056~35.65；P=0.039）。结论 PA/A与AECOPD患者病情严重程度相关，PA/A>1可能是AECOPD患者多次住院风险的独立危险因素。

慢性阻塞性肺疾病急性加重患者肺动脉直径与主动脉直径比值的临床意义

宋薇¹, 张强¹, 郑锐¹, 娜合木古丽·阿依达尔汗², 栗伟³, 谭明旗¹

1. 中国医科大学附属盛京医院呼吸内科, 沈阳 110022;
2. 新疆塔城地区人民医院呼吸科, 新疆 塔城 834300;
3. 东北大学医学影像智能计算教育部重点实验室, 沈阳 110819

收稿日期:2020-11-13出版日期:2021-07-30发布日期:2021-06-24
通讯作者:谭明旗E-mail:tanmq@sj-hospital.org
作者简介:宋薇(1990-),女,医师,硕士.
基金资助:辽宁省临床能力建设项目（LNCCC-D14-2015）；沈阳市科学技术计划（18-014-4-17）；新疆维吾尔自治区自然科学基金（2020D01A123）；东北大学医学影像智能计算教育部重点实验室开放课题（17-134-8-00）


关键词: 肺动脉直径与主动脉直径比值, 慢性阻塞性肺疾病急性加重, 住院风险
Abstract: Objective To investigate the clinical significance of the pulmonary artery diameter to aortic diameter ratio (PA/A) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and its correlation with hospitalization risk. Methods The clinical data of 223 patients with AECOPD in the Department of Pulmonary and Critical Care Medicine of our hospital were retrospectively analyzed from October 2014 to October 2019. PA/A was calculated based on chest CT measurement,and the clinical indicators of patients in the PA/A ≤ 1 and PA/A >1 groups were compared using the t test or χ² test. Based on the admission status of patients within a year,they were divided either into the one time leading to hospitalization (one time) group or the over two times leading to hospitalization (over two times) group. The difference in clinical indicators between the two groups was also compared using t test or χ² test,and logistic regression analysis was used to analyze statistically significant (P<0.05) indicators. Results Compared to the PA/A ≤ 1 group,the PA/A >1 group had a history of smoking,increased hospitalization time,increased body mass index,increased PaCO₂ and HCO₃^- levels,increased times leading to hospitalization one year before admission,worse lung function,and had more mechanical ventilation treatments,which were all statistically significant (P<0.05). Compared to the one time group,the FEV1%,FVC%,FEV1/FVC,HCO₃^-,pulmonary artery diameter,length of hospital stay,and PA/A >1 proportion were higher in the over two group (P<0.05). Moreover,logistic regression analysis showed that PA/A >1 was an independent risk factor for over two times admissions within the year before admission (OR=6.150;95% CI:1.056-35.65;P=0.039). Conclusion PA/A is associated with the AECOPD severity,and PA/A >1 is an independent risk factor for multiple admissions in AECOPD patients.
Key words: pulmonary artery diameter to aortic diameter ratio, acute exacerbation of chronic obstructive pulmonary disease, risk of hospitalization
PDF全文下载地址:

https://journal.cmu.edu.cn/CN/article/downloadArticleFile.do?attachType=PDF&id=2796