Associate Professor of Pulmonology Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.
Assistant Professor of Emergency Medicine, Department of Emergency Medicine, Kerman University of Medical Sciences, Clinical Research Center, Afzalipour Hospital, Kerman, Iran.
Am J Emerg Med. 2018 Feb;36(2):277-280. doi: 10.1016/j.ajem.2017.08.014. Epub 2017 Aug 5.
Pulmonary hypertension (PH) is one of the most common complications of COPD (chronic obstructive pulmonary disease), but its severe form is uncommon. Various factors play an important role in the occurrence and severity of pulmonary hypertension in patients.
This cross-sectional study was performed on patients with COPD referred to an emergency department over a one-year period. The tests-including complete blood count (CBC) and arterial blood gas (ABG), pulmonary functional test (PFT) and echocardiography-were performed for all patients to measure mPAP (mean pulmonary artery pressure), ejection fraction (EF) and body mass index (BMI). The prevalence of severe pulmonary hypertension and its associated factors were investigated in these patients.
A total of 1078 patients was included in the study, of whom 628 (58.3%) were male and 450 (41.7%) were female. The mean age of the patients undergoing the study was 70.1±12.2. A total of 136 (13.7%) of them had mPAP (mm Hg)≥40mm Hg as severe pulmonary hypertension. Following multivariable analysis by using the backward conditional method, it was shown that seven variables had a significant correlation with severe PH.
The results showed that there is an independent correlation between hypoxia, hypopnea and compensatory metabolic alkalosis, polycythemia, left ventricular dysfunction, emaciation, and cachectic with severe pulmonary hypertension. The prevalence of severe PH in these patients was 13.7%.
肺动脉高压（PH）是 COPD（慢性阻塞性肺疾病）最常见的并发症之一，但严重形式并不常见。各种因素在患者肺动脉高压的发生和严重程度中起重要作用。
这是一项为期一年的回顾性研究，对因 COPD 而到急诊就诊的患者进行了研究。对所有患者进行了包括全血细胞计数（CBC）和动脉血气分析（ABG）、肺功能测试（PFT）和超声心动图在内的检查，以测量平均肺动脉压（mPAP）、射血分数（EF）和体重指数（BMI）。调查了这些患者中严重肺动脉高压的患病率及其相关因素。
共有 1078 名患者纳入研究，其中 628 名（58.3%）为男性，450 名（41.7%）为女性。研究对象的平均年龄为 70.1±12.2 岁。共有 136 名（13.7%）患者 mPAP（mmHg）≥40mmHg，为严重肺动脉高压。采用后向条件法进行多变量分析后，有 7 个变量与严重 PH 有显著相关性。
结果表明，缺氧、呼吸暂停和代偿性代谢性碱中毒、红细胞增多症、左心室功能障碍、消瘦和恶病质与严重肺动脉高压之间存在独立相关性。这些患者中严重 PH 的患病率为 13.7%。
