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目的探讨肺动脉压与慢性阻塞性肺疾病(COPD)患者左心室舒张功能的关系。方法选取2013年6月—2014年6月伊犁哈萨克自治州友谊医院收治的COPD患者70例作为病例组,另选取同时期在本院体检健康成年人40例作为对照组。根据肺动脉压将病例组患者分为轻度升高亚组45例、中度升高亚组15例及重度升高亚组10例。检测4组受检者舒张早期左房室瓣血流速度(E值)、舒张晚期左房室瓣血流速度(A值)、心室收缩期峰值速度(S值)、心室舒张期峰值速度(D值)及肺动脉压。结果对照组受检者E值高于轻度升高组、中度升高组及重度升高组,D值低于轻度升高组、中度升高组及重度升高组(P<0.05),而轻度升高组、中度升高组及重度升高组患者E值、D值比较,差异无统计学意义(P>0.05);4组受检者A值、S值比较,差异无统计学意义(P>0.05)。对照组患者左心室舒张功能优于轻度升高组、中度升高组及重度升高组(P<0.05);而轻度升高组、中度升高组及重度升高组患者左心室舒张功能比较,差异无统计学意义(P>0.05)。Spearman秩相关分析结果显示,肺动脉压与E值呈负相关(rs=-5.44,P<0.05),与左心室舒张功能呈正相关(rs=0.40,P<0.05)。结论肺动脉压与COPD患者左心室舒张功能存在正相关关系,肺动脉高压可能是导致COPD患者左心室舒张功能障碍的原因之一。
Objective To investigate the relationship between left ventricular diastolic function and pulmonary arterial pressure in patients with chronic obstructive pulmonary disease (COPD). Methods Seventy patients with COPD admitted to the Friendship Hospital of Ili Kazakh Autonomous Prefecture from June 2013 to June 2014 were selected as the case group. Forty healthy adults in the same period were selected as the control group. According to pulmonary arterial pressure, the patients in the case group were divided into mild increase subgroup of 45 cases, moderate increase subgroup of 15 cases and severe subgroup of 10 cases. The blood flow velocity (E), left ventricular aortic valve velocity (A), peak systolic velocity (S), and diastolic peak velocity D value) and pulmonary artery pressure. Results The value of E in the control group was higher than that in the mildly elevated group, the moderately elevated group and the severely elevated group, and the D value was lower in the control group than in the mildly elevated group, the moderately elevated group and the severely elevated group (P < 0.05). There was no significant difference in E value and D value among mild elevation group, moderate increase group and severe increase group (P> 0.05). The A value and S value of the four groups were compared , The difference was not statistically significant (P> 0.05). The left ventricular diastolic function of the control group was better than that of the moderately elevated group and the moderately elevated group (P <0.05), while the left ventricular diastolic function of the mildly elevated group, the moderately elevated group and the severely elevated group Ventricular diastolic function, the difference was not statistically significant (P> 0.05). Spearman rank correlation analysis showed that pulmonary arterial pressure was negatively correlated with E value (rs = -5.44, P <0.05), and positively correlated with left ventricular diastolic function (rs = 0.40, P <0.05). Conclusions There is a positive correlation between pulmonary artery pressure and left ventricular diastolic function in patients with COPD. Pulmonary hypertension may be one of the causes of left ventricular diastolic dysfunction in COPD patients.