Department of Respiratory Medicine, Yijishan Hospital, Wannan Medical College, Wuhu, People's Republic of China.
Department of Interventional Therapy, Yijishan Hospital, Wannan Medical College, Wuhu, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2022 May 16;17:1157-1165. doi: 10.2147/COPD.S357696. eCollection 2022.
The main pulmonary artery (PA) to ascending aorta diameter ratio (PA/A) greater than one is a promising indicator of pulmonary hypertension (PH) in acute exacerbation (AE) of chronic obstructive pulmonary disease (COPD) (AECOPD). This study aims to disclose the associations between the PA/A ratio and clinical outcomes in hospitalized patients with AECOPD.
Consecutive AECOPD patients admitted to the Department of Respiratory Medicine from September 2017 to July 2021 were reviewed. The treatment success of AECOPD patients was defined as improvement in the clinical condition when discharged from the hospital. Conversely, treatment failure was considered to be an event of in-hospital death or deterioration of the clinical condition prior to discharge.
A total of 118 individuals were ultimately reviewed in this study: 74 individuals with a PA/A ratio <1 and 44 individuals with a PA/A ratio ≥1. The outcomes of 21 patients were treatment failure, and 97 patients were considered successes. Patients with a PA/A ratio ≥1 had significantly higher PaCO2, red cell distribution width, brain natriuretic peptide, PA diameters, RICU admission rates, and proportions of treatment failure than patients with PA/A ratios <1 (P < 0.05). The PA diameter and PA/A ratio were significantly increased in the treatment failure group compared with the success group (P < 0.05). A survival analysis indicated that patients with a PA/A ratio ≥1 had worse outcomes than patients with a PA/A ratio <1 during hospitalization (P < 0.05). A multivariate analysis showed that a PA/A ratio ≥1 was an independent risk factor for treatment failure in patients with AECOPD.
AECOPD patients with a PA/A ratio ≥1 may have worse outcomes during hospitalization. A PA/A ratio ≥1 may be a promising predictor of treatment failure in patients with AECOPD.
主肺动脉（PA）与升主动脉直径比（PA/A）大于 1 是慢性阻塞性肺疾病（COPD）急性加重（AE）患者发生肺动脉高压（PH）的一个有前途的指标。本研究旨在揭示住院 AECOPD 患者的 PA/A 比值与临床结局之间的关系。
回顾性分析 2017 年 9 月至 2021 年 7 月呼吸内科收治的 AECOPD 患者。AECOPD 患者的治疗成功定义为出院时临床状况改善。相反，治疗失败被认为是住院期间死亡或临床状况恶化的事件。
本研究共纳入 118 例患者：PA/A 比值<1 的 74 例和 PA/A 比值≥1 的 44 例。21 例患者的结局为治疗失败，97 例患者为治疗成功。PA/A 比值≥1 的患者 PaCO2、红细胞分布宽度、脑钠肽、PA 直径、入住 RICU 率和治疗失败比例均明显高于 PA/A 比值<1 的患者（P<0.05）。治疗失败组的 PA 直径和 PA/A 比值明显高于治疗成功组（P<0.05）。生存分析表明，住院期间 PA/A 比值≥1 的患者预后较 PA/A 比值<1 的患者差（P<0.05）。多因素分析显示，PA/A 比值≥1 是 AECOPD 患者治疗失败的独立危险因素。
PA/A 比值≥1 的 AECOPD 患者住院期间可能预后较差。PA/A 比值≥1 可能是预测 AECOPD 患者治疗失败的一个有前途的指标。
