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慢性阻塞性肺疾病对腹主动脉瘤患病率及术后结局的影响：一项荟萃分析。

Chronic obstructive pulmonary disease effect on the prevalence and postoperative outcome of abdominal aortic aneurysms: A meta-analysis.

作者信息

Xiong Jiang, Wu Zhongyin, Chen Chen, Guo Wei

机构信息

Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing, P.R. China.

Department of General Surgery, Affiliated Hospital of Chengde Medical College, Chengde, Hebei, P.R. China.

出版信息

Sci Rep. 2016 Apr 26;6:25003. doi: 10.1038/srep25003.

DOI:10.1038/srep25003
PMID:27112336
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4845024/
Abstract

Epidemiologic evidence suggested chronic obstructive pulmonary disease (COPD) might increase risk for abdominal aortic aneurysm (AAA). However, the association between COPD and AAA remains inconclusive. We searched PubMed and Cochrane databases until June 2015. Forty-eight articles were included for meta-analysis. COPD was found to be positively associated with AAA, regardless of study design and smoking status. AAA mortality is higher among COPD patients compared with non-COPD patients (postoperative [adjusted OR 2.11; 95% CI 1.33-3.34]; long-term [adjusted OR 1.70; 95% CI 1.37-2.12]). But the association between postoperative mortality and COPD was not found to be significant in patients underwent endovascular aneurysm repair (mixed OR 2.53; 95% CI 0.70-9.18). Rupture AAA may increase the postoperative mortality in COPD patients (rupture [adjusted OR 4.75; 95% CI 2.07-10.89]; non-rupture [adjusted OR 1.97; 95% CI 1.11-3.49]). The AAA postoperative morbidity was found to be positively associated with COPD (adjusted OR 1.59; 95% CI 1.14-2.21). Increased COPD severity may increase the long-term mortality (medical versus oxygen dependent: [OR 1.26; 95% CI 1.07-1.49] versus [OR 2.79; 95% CI 2.24-3.49]). In conclusion, COPD may increase the risk of AAA, morbidity and mortality of AAA patients underwent endovascular aortic repair.

摘要

流行病学证据表明，慢性阻塞性肺疾病（COPD）可能会增加腹主动脉瘤（AAA）的发病风险。然而，COPD与AAA之间的关联仍不明确。我们检索了截至2015年6月的PubMed和Cochrane数据库。纳入48篇文章进行荟萃分析。结果发现，无论研究设计和吸烟状况如何，COPD与AAA呈正相关。与非COPD患者相比，COPD患者的AAA死亡率更高（术后[调整后OR 2.11；95%CI 1.33 - 3.34]；长期[调整后OR 1.70；95%CI 1.37 - 2.12]）。但在接受血管内动脉瘤修复的患者中，未发现术后死亡率与COPD之间存在显著关联（混合OR 2.53；95%CI 0.70 - 9.18）。破裂性AAA可能会增加COPD患者的术后死亡率（破裂[调整后OR 4.75；95%CI 2.07 - 10.89]；非破裂[调整后OR 1.97；95%CI 1.11 - 3.49]）。发现AAA术后发病率与COPD呈正相关（调整后OR 1.59；95%CI 1.14 - 2.21）。COPD严重程度增加可能会增加长期死亡率（药物治疗与氧依赖：[OR 1.26；95%CI 1.07 - 1.49] 对比 [OR 2.79；95%CI 2.24 - 3.49]）。总之，COPD可能会增加AAA的风险、接受血管内主动脉修复的AAA患者的发病率和死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef3f/4845024/ebe4cfc85623/srep25003-f7.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef3f/4845024/edfa9402079e/srep25003-f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef3f/4845024/51e928bde88c/srep25003-f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef3f/4845024/ebe4cfc85623/srep25003-f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef3f/4845024/2106997d92fc/srep25003-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef3f/4845024/c6a81844ac07/srep25003-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef3f/4845024/8260fb719abf/srep25003-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef3f/4845024/812641e8f95c/srep25003-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef3f/4845024/edfa9402079e/srep25003-f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef3f/4845024/51e928bde88c/srep25003-f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef3f/4845024/ebe4cfc85623/srep25003-f7.jpg

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