老年稳定心力衰竭患者中慢性阻塞性肺疾病的发生和影响。
Occurrence and impact of chronic obstructive pulmonary disease in elderly patients with stable heart failure.
机构信息
Department of Clinical and Experimental Medicine, University of Ferrara, Ferrara, Italy.
出版信息
Respirology. 2013 Jan;18(1):125-30. doi: 10.1111/j.1440-1843.2012.02264.x.
BACKGROUND AND OBJECTIVE
The coexistence of chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) increases with age. The occurrence, prognosis and therapeutic implications of concurrent COPD in elderly patients with CHF were investigated.
METHODS
One hundred and eighteen consecutive patients, ≥ 65 years old with ≥ 10 pack/years of smoking and with a verified diagnosis of CHF in stable condition, were enrolled. They were followed for a mean of 1029 (range 758-1064) days. All patients had spirometry and the diagnosis and classification of COPD were made according to Global Initiative for Chronic Obstructive Lung Disease guidelines.
RESULTS
The mean occurrence of COPD was 30% (90% confidence interval: 24-37%). At baseline in patients with CHF and COPD, there was a shorter 6-min walk distance, lower arterial oxygen tension, glomerular filtration rate and higher N-terminal pro-B-type natriuretic peptide (all P < 0.05). The prescription of CHF therapies, including β-blockers, was similar in the two groups. After follow up, the presence of COPD in patients with CHF did not appear to influence survival.
CONCLUSIONS
COPD is relatively frequent in elderly patients with CHF. COPD did not alter survival.
背景与目的
慢性阻塞性肺疾病（COPD）和慢性心力衰竭（CHF）共存的情况会随着年龄的增长而增加。本研究旨在探讨老年 CHF 患者并发 COPD 的发生情况、预后及其对治疗的影响。
方法
本研究共纳入 118 例年龄≥65 岁、吸烟≥10 包/年且稳定期 CHF 确诊患者，平均随访 1029（758-1064）天。所有患者均进行了肺功能检查，根据全球慢性阻塞性肺疾病倡议（GOLD）指南诊断和分类 COPD。
结果
COPD 的平均发生率为 30%（90%置信区间：24-37%）。在合并 COPD 的 CHF 患者中，6 分钟步行距离较短、动脉血氧分压较低、肾小球滤过率较低和 N 端脑利钠肽前体（NT-proBNP）较高（均 P＜0.05）。两组 CHF 治疗方案的处方（包括β受体阻滞剂）相似。随访后，CHF 患者并发 COPD 似乎并未影响其生存率。
结论
COPD 在老年 CHF 患者中较为常见。COPD 不会改变患者的生存率。
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