Department of Pulmonary and Critical Care Medicine, Institute of Respiratory Disease, The First Hospital of China Medical University, No. 155 Nanjing North Street, Shenyang, 110001, China.
Department of Critical Care Medicine, The affiliated hospital of Qingdao university, Qingdao, China.
BMC Pulm Med. 2024 Feb 9;24(1):77. doi: 10.1186/s12890-024-02879-0.
This study aimed to investigate the risk factors for peripheral arteriosclerosis (PAS) and peripheral artery disease (PAD) in chronic obstructive pulmonary disease (COPD) patients and potential ultrasound indicators that could be used to improve detection.
Outpatients seeking care between January 1, 2017, and December 31, 2020, in The First Affiliated Hospital of China Medical University were prospectively recruited. Subjects were divided into COPD and non-COPD (control) groups, and the COPD group was further divided into PAD and non-PAD subgroup, at the same time, PAS and non-PAS subgroup. Indicators of PAD -ankle-brachial index (ABI), indicators of PAS- pulse wave velocity (PWV), and ultrasound indices -peak systolic blood flow velocity (PSV) and blood flow acceleration velocity (AccV) were compared.
Sixty-nine (61.6%) of 112 enrolled subjects had COPD. COPD patients had higher age, and blood pressure (BP)lower than controls. Seventeen (24.6%) COPD patients had PAD, the prevalence of PAD increases with the decrease of lung function, and seven (16.3%) non-COPD patients had PAD, however, there was no significant statistical difference between COPD and non-COPD groups. Fifty (72.5%) COPD patients had PAS, and thirty-four (79.1%) non-COPD patients had PAS, however, there was also no significant difference. The PAS subgroup had higher age, body mass index(BMI), body fat percentage(BFP), lower FEV1 and FEV1/FVC, as well as higher levels of right brachial artery and left dorsalis pedis artery AccV. Factors that correlated with ABI were 6MWD, post-bronchodilator FEV1, FEV1/ FVC, and maximal middle expiratory flow between 75% and 25% of FVC. Age, BP, and 6MWD, but not pulmonary function, were associated with brachial-ankle PWV (baPWV). There was a positive correlation between baPWV and radial artery AccV bilaterally.
Radial artery AccV correlated well with baPWV, which suggests that ultrasound could be used to assess both morphological and functional changes in vessels, may serving as a better method to identify PAS in high-risk COPD patients.
本研究旨在探讨慢性阻塞性肺疾病(COPD)患者外周动脉硬化(PAS)和外周动脉疾病(PAD)的危险因素,以及可能用于改善检测的潜在超声指标。
本研究前瞻性招募了 2017 年 1 月 1 日至 2020 年 12 月 31 日期间在中国医科大学第一附属医院就诊的门诊患者。受试者被分为 COPD 组和非 COPD(对照组),COPD 组进一步分为 PAD 组和非 PAD 亚组,同时还分为 PAS 组和非 PAS 亚组。比较了 PAD 的踝臂指数(ABI)、PAS 的脉搏波速度(PWV)、超声指标-收缩期血流速度峰值(PSV)和血流加速速度(AccV)等指标。
在纳入的 112 名受试者中,有 69 名(61.6%)患有 COPD。COPD 患者的年龄较大,血压(BP)较对照组低。17 名(24.6%)COPD 患者患有 PAD,随着肺功能的降低,PAD 的患病率增加,7 名(16.3%)非 COPD 患者患有 PAD,但 COPD 组和非 COPD 组之间无显著统计学差异。50 名(72.5%)COPD 患者患有 PAS,34 名(79.1%)非 COPD 患者患有 PAS,但两组之间也无显著差异。PAS 亚组的年龄较大,体重指数(BMI)、体脂百分比(BFP)较高,FEV1 和 FEV1/FVC 较低,右侧肱动脉和左侧足背动脉 AccV 水平较高。与 ABI 相关的因素有 6MWD、支气管扩张后 FEV1、FEV1/FVC 和最大呼气中期流量在 75%和 25%的 FVC 之间。年龄、BP 和 6MWD,但不是肺功能,与肱踝 PWV(baPWV)相关。双侧桡动脉 AccV 与 baPWV 呈正相关。
桡动脉 AccV 与 baPWV 相关性良好,提示超声检查可用于评估血管的形态和功能变化,可能是识别高危 COPD 患者 PAS 的更好方法。