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与健康受试者相比,通过无创外周动脉张力测定法评估慢性阻塞性肺疾病患者的内皮功能障碍。

Endothelial dysfunction assessment by noninvasive peripheral arterial tonometry in patients with chronic obstructive pulmonary disease compared with healthy subjects.

作者信息

Malerba Mario, Radaeli Alessandro, Nardin Matteo, Clini Enrico, Carpagnano Giovanna Elisiana, Sciatti Edoardo, Salghetti Francesca, Bonadei Ivano, Platto Fabio, Vizzardi Enrico

机构信息

Department of Internal Medicine, University of Brescia and ASST Spedali Civili, Brescia, Italy.

Department of Emergency ASST Spedali Civili, Brescia, Italy.

出版信息

Clin Respir J. 2018 Apr;12(4):1466-1472. doi: 10.1111/crj.12686. Epub 2017 Aug 16.

Abstract

INTRODUCTION

Patients with chronic obstructive pulmonary disease (COPD) have an increased risk of cardiovascular disease. The endothelial dysfunction likely plays a central role in increasing cardiovascular risk.

OBJECTIVES

This cross-sectional, study investigated the prevalence and extent of endothelial dysfunction in patients with stable COPD.

METHODS

Peripheral arterial tonometry (PAT) was measured by post-ischemic reactive hyperemia index (RHI) in 16 COPD patients, 16 healthy controls and 16 subjects with treated systemic arterial hypertension (AH) and analysed with covariates condition (dyslipidemia, and medications).

RESULTS

The prevalence of endothelial dysfunction was significantly higher in COPD group than in the other groups. Mean RHI was significantly lower in COPD patients compared with the other groups. At linear regression FEV and RHI were directly correlated (Spearman index = 0.553; P = .026). COPD patients in groups C and D according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages showed lower RHI compared with patients classified as A and B (P < .01). At multiple regression analysis the presence of dyslipidemia, COPD and AH were associated with the presence of endothelial dysfunction.

CONCLUSIONS

Endothelial dysfunction in stable COPD patients is probably implicated in the high cardiovascular comorbidity. This study suggests the potential utility of endothelial dysfunction evaluation in patients with COPD to a timely assessment and treatment for cardiac complications.

摘要

引言

慢性阻塞性肺疾病(COPD)患者患心血管疾病的风险增加。内皮功能障碍可能在增加心血管风险中起核心作用。

目的

本横断面研究调查了稳定期COPD患者内皮功能障碍的患病率及程度。

方法

采用缺血后反应性充血指数(RHI)通过外周动脉张力测定法(PAT)对16例COPD患者、16例健康对照者和16例接受治疗的系统性动脉高血压(AH)患者进行测量,并对协变量情况(血脂异常和药物治疗)进行分析。

结果

COPD组内皮功能障碍的患病率显著高于其他组。与其他组相比,COPD患者的平均RHI显著更低。在线性回归分析中,第一秒用力呼气容积(FEV)与RHI呈直接相关(斯皮尔曼指数=0.553;P=0.026)。根据慢性阻塞性肺疾病全球倡议(GOLD)分期,C组和D组的COPD患者的RHI低于A组和B组患者(P<0.01)。在多元回归分析中,血脂异常、COPD和AH的存在与内皮功能障碍的存在相关。

结论

稳定期COPD患者的内皮功能障碍可能与高心血管合并症有关。本研究提示评估COPD患者内皮功能障碍对于及时评估和治疗心脏并发症具有潜在作用。

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