Frantz Sophia, Nihlén Ulf, Dencker Magnus, Engström Gunnar, Löfdahl Claes-Göran, Wollmer Per
Clinical Physiology and Nuclear Medicine unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
Clin Physiol Funct Imaging. 2012 Mar;32(2):120-5. doi: 10.1111/j.1475-097X.2011.01065.x. Epub 2011 Nov 10.
Previous studies on associations between reduced lung function and cardiovascular disease (CVD) have mainly been based on forced expiratory volume in 1-s (FEV(1) ) and vital capacity (VC). This study examined potential associations between five different lung function variables and plaques in the internal carotid artery (ICA).
Subjects (n = 450) from a previous population-based respiratory questionnaire survey [current smokers without lower respiratory symptoms, subjects with a self-reported diagnosis of chronic obstructive pulmonary disease (COPD) and never-smokers without lower respiratory symptoms] were examined using spirometry, body plethysmography and measurements of diffusing capacity for CO (D(L,CO) ). Plaques in the ICA were assessed by ultrasonography.
Two hundred and twenty subjects were current smokers, 139 ex-smokers and 89 never-smokers. COPD was diagnosed in 130 subjects (GOLD criteria). Plaques in the ICA were present in 231 subjects (52%). General linear analysis with adjustment for established risk factors for atherosclerosis, including C-reactive protein, showed that D(L,CO) was lower [77.4% versus 83.7% of predicted normal (PN), P = 0.014] and residual volume (RV) was higher (110.3% versus 104.8% of PN, P = 0.020) in subjects with than without plaques in the ICA. This analysis did not show any statistically significant association between plaques and FEV(1) or VC.
The occurrence of plaques in the ICA was associated with low D(L,CO) and high RV, but not significantly with FEV(1) or COPD status. The results suggest that the relationships between reduced lung function, COPD and CVD are complex and not only linked to bronchial obstruction and low-grade systemic inflammation.
既往关于肺功能降低与心血管疾病（CVD）之间关联的研究主要基于第一秒用力呼气容积（FEV₁）和肺活量（VC）。本研究调查了五种不同肺功能变量与颈内动脉（ICA）斑块之间的潜在关联。
对先前一项基于人群的呼吸问卷调查中的受试者（n = 450）[目前无下呼吸道症状的吸烟者、自我报告诊断为慢性阻塞性肺疾病（COPD）的受试者以及无下呼吸道症状的从不吸烟者]进行肺量计、体容积描记法检查以及一氧化碳弥散量（Dₗ,CO）测量。通过超声检查评估ICA中的斑块。
220名受试者为目前吸烟者，139名是既往吸烟者，89名是从不吸烟者。130名受试者（根据全球慢性阻塞性肺疾病倡议组织标准）被诊断为COPD。231名受试者（52%）存在ICA斑块。在对包括C反应蛋白在内的既定动脉粥样硬化危险因素进行校正的一般线性分析中，与ICA无斑块的受试者相比，有斑块的受试者Dₗ,CO较低[占预计正常值（PN）的77.4%对83.7%，P = 0.014]，残气量（RV）较高（占PN的110.3%对104.8%，P = 0.020）。该分析未显示斑块与FEV₁或VC之间存在任何统计学上的显著关联。
ICA中斑块的出现与低Dₗ,CO和高RV相关，但与FEV₁或COPD状态无显著关联。结果表明，肺功能降低、COPD与CVD之间的关系很复杂，且不仅与支气管阻塞和低度全身炎症有关。
