初诊慢性阻塞性肺疾病伴高压病临床症状、生存质量及实验室指标研究

doi:10.3969/j.issn.1006-5725.2024.11.014

Abstract

Abstract:

Objective We tried to investigate the difference of respiratory symptoms， quality of life， blood routine examination and bone metabolism in patients with newly diagnosed chronic obstructive pulmonary disease with and without hypertension. Methods A total of 92 newly diagnosed patients with chronic obstructive pulmonary disease and hypertension treated in our hospital from January 2019 to April 2022 were selected as the observation group， and 92 newly diagnosed patients with COPD without hypertension were selected as the control group. The modified British Medical Research Council Respiratory Questionnaire （mMRC）， Chronic Obstructive Pulmonary Disease Self Assessment Test Questionnaire （CAT）， Global Initiative for Chronic Obstructive Pulmonary Disease （GOLD）， SF-36 scale scores， blood routine examination and bone metabolism indexes were different. Results The rate of mMRC grade ≥ 2 and CAT score of the observation group were significantly higher than those of the control group （P < 0.05）， while the SF-36 score was significantly lower than that of the control group （P < 0.05）. The GOLD grading of the observation group was significantly higher than that of the control group （P < 0.05）. The forced vital capacity （FVC） and the first second expiratory volume （FEV1） in the observation group were significantly lower than those in the control group （P < 0.05）. There was no significant difference between the observation group and the control group in white blood cell count （WBC）， neutrophil count （NEUT） and lymphocyte count （LYM） etc （P > 0.05）. The bone mineral density of the femoral neck and blood calcium in the observation group were significantly lower than those in the control group （P < 0.05）， while the parathyroid hormone （PTH） and osteocalcin （BGP） were significantly higher than those in the control group （P < 0.05）. The levels of C-reactive protein （CRP）， procalcitonin （PCT）， interleukin-6 （IL-6）， IL-4， and IL-10 in the observation group were significantly higher than those in the control group （P < 0.05）. The hypertension grade in the observation group was positively correlated with mMRC grade， CAT score and GOLD grade （r_s = 0.455， 0.302 and 0.501， P < 0.05）， but negatively correlated with FVC and FEV1 （r_s = -0.311 and -0.334， P < 0.05）. Conclusion The newly diagnosed patients with chronic obstructive pulmonary disease and hypertension have severe respiratory symptoms， poor quality of life， and an increased risk of osteoporosis， and the patient's blood pressure is related to the degree of respiratory symptoms.

Key words: chronic obstructive pulmonary disease, hypertension, respiratory symptoms, quality of life, routine blood test, bone metabolism

CLC Number:

R563

Yanqing MAO,Ya′nan WANG,Jie. LI. The clinical symptoms， quality of life and laboratory indexes of newly diagnosed chronic obstructive pulmonary disease with hypertension[J]. The Journal of Practical Medicine, 2024, 40(11): 1549-1553.

Figures/Tables 6

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References 25

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组别	例数	性别［例（%）］		年龄（岁）	体质量指数（kg/m²）
组别	例数	男	女	年龄（岁）	体质量指数（kg/m²）
观察组	92	56（60.87）	36（36.96）	44.49 ± 9.21	22.50 ± 2.00
对照组	92	60（65.22）	32（34.78）	42.02 ± 9.18	22.81 ± 2.08
t/χ²值		0.177		1.260	-1.030
P值		0.674		0.210	0.304

组别	例数	mMRC评级 ≥ 2级（%）	CAT评分（分）	SF-36评分（分）
观察组	92	34（36.96）	10.54 ± 1.82	61.10 ± 8.20
对照组	92	11（11.96）	8.02 ± 1.50	79.29 ± 8.11
t/χ²值		15.561	10.249	-15.128
P值		0.000	0.000	0.000

指标	观察组（n = 92）	对照组（n = 92）	t/Z值	P值
GOLD分级
Ⅰ级	22（23.91）	48（52.17）	-4.806	0.000
Ⅱ级	28（30.43）	29（31.52）
Ⅲ级	23（25.00）	11（11.96）
Ⅳ级	19（20.65）	4（4.35）
FVC（x ± s，L）	77.23 ± 6.76	92.10 ± 8.11	-13.509	0.000
FEV1（x ± s，L）	45.54 ± 7.71	72.21 ± 8.04	-22.964	0.000

指标	观察组（n = 92）	对照组（n = 92）	t值	P值
WBC（×10⁹/L）	6.20 ± 1.10	6.10 ± 1.02	0.639	0.523
NEUT（×10⁹/L）	3.65 ± 0.82	3.55 ± 0.90	0.788	0.432
LYM（×10⁹/L）	2.03 ± 0.56	2.06 ± 0.62	-0.344	0.731
Eos（×10⁹/L）	0.21 ± 0.09	0.20 ± 0.08	0.797	0.427
Mon（×10⁹/L）	0.52 ± 0.22	0.48 ± 0.20	1.290	0.199
Hb（g/L）	135.53 ± 11.02	134.49 ± 10.14	0.666	0.506
PLT（×10⁹/L）	191.12 ± 12.04	193.32 ± 11.82	-1.251	0.213
FBG（mmol/L）	6.10 ± 1.32	5.78 ± 1.22	1.708	0.089
股骨颈骨密度（g/cm²）	0.54 ± 0.11	0.64 ± 0.10	-6.452	0.000
PTH（ng/L）	601.11 ± 70.20	556.65 ± 63.34	4.510	0.000
TALP（IU/L）	84.43 ± 11.45	82.29 ± 12.02	1.236	0.218
BGP（mg/L）	6.82 ± 1.22	6.13 ± 1.12	3.996	0.000
血钙（mmol/L）	2.12 ± 0.43	2.40 ± 0.49	-4.120	0.000

指标	观察组（n = 92）	对照组（n = 92）	t值
CRP（mg/L）	9.21 ± 1.12	6.97 ± 1.32	9.951
PCT（ng/mL）	2.01 ± 0.42	1.54 ± 0.33	-6.874
IL-6（pg/mL）	13.43 ± 2.51	11.32 ± 2.32	-4.666
IL-4（pg/mL）	18.84 ± 3.03	15.54 ± 3.11	-5.628
IL-10（pg/mL）	15.56 ± 2.92	10.45 ± 2.88	-9.297

The clinical symptoms， quality of life and laboratory indexes of newly diagnosed chronic obstructive pulmonary disease with hypertension

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指标	高血压分级
指标	r_s	P值
mMRC评级	0.455	0.000
CAT评分	0.302	0.012
SF-36评分	0.101	0.659
GOLD分级	0.501	0.000
FVC	-0.311	0.022
FEV1	-0.334	0.015
WBC	0.082	0.873
NEUT	0.018	0.696
LYM	0.022	0.712
Eos	0.019	0.903
Mon	0.101	0.655
Hb	0.062	0.704
PLT	0.112	0.612
FBG	0.011	0.812
股骨颈骨密度	0.082	0.844
PTH	0.132	0.915
TALP	0.121	0.783
BGP	0.112	0.755
血钙	0.109	0.722
CRP	0.114	0.675
PCT	0.182	0.622
IL-6	0.214	0.701
IL-4	0.113	0.443
IL-10	0.072	0.812

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