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心力衰竭患者中慢性阻塞性肺疾病的患病率及临床相关性:一项中国的横断面研究

Prevalence and clinical correlates of chronic obstructive pulmonary disease in heart failure patients: a cross-sectional study in China.

作者信息

Zhu Ailing, Hu Manman, Ge Dehai, Zhang Xiujian, Zhang Jinfeng, Wang Yangchun, Yao Xin, Liu Junjun

机构信息

Nanjing Meishan Hospital, Nanjing, China.

The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Front Med (Lausanne). 2025 Feb 3;12:1477388. doi: 10.3389/fmed.2025.1477388. eCollection 2025.

Abstract

BACKGROUND

Despite chronic obstructive pulmonary disease's (COPD)'s prevalence in the general populace, its incidence in heart failure (HF) patients is understudied. This study aimed to assess COPD prevalence and clinical associations in Chinese HF patients.

METHODS

From the Chinese Heart Failure Study, demographic and clinical details of 2008 HF patients were analyzed. Divided into 233 COPD cases and 1775 non-COPD controls, a multivariable logistic regression identified factors linked to COPD onset in HF, with thorough examination of intergroup clinical differences.

RESULTS

The incidence of COPD in HF individuals was 11.60% (233/2008). The COPD subgroup featured a higher ratio of individuals over 60 and males, alongside lower systolic blood pressure (SBP), body mass index (BMI), higher Charlson Comorbidity Index (CCI) scores, and increased PaCO₂ levels ( < 0.05). Type II respiratory failure and right ventricular dysfunction (RVD) were more prevalent in the COPD subgroup ( < 0.001). Binary logistic regression, after adjustments, indicated positive associations between COPD and age over 60 (OR = 3.831, 95%CI: 1.085-13.526,  = 0.037), male sex (OR = 1.587, 95%CI: 1.032-2.441,  = 0.036), higher CCI (OR = 2.214, 95%CI: 1.796-2.729,  < 0.001), elevated PaCO (OR = 1.035, 95%CI: 1.015-1.055,  < 0.001), and RVD (OR = 0.605, 95%CI: 0.119-3.063,  = 0.544). Inversely, higher SBP (OR = 0.990, 95%CI: 0.982-0.998,  = 0.020) and log (triglycerides) (OR = 0.183, 95%CI: 0.064-0.552,  = 0.002) were negatively correlated with COPD in HF patients.

CONCLUSION

In a large cohort of Chinese Heart Failure (HF) patients, our study revealed a notable COPD prevalence. Key risk factors included age, sex, elevated PaCO, CCI score, and right heart failure, while higher SBP and triglyceride levels offered protection. These insights lay groundwork for probing disease mechanisms and therapeutic approaches.

摘要

背景

尽管慢性阻塞性肺疾病(COPD)在普通人群中普遍存在,但在心力衰竭(HF)患者中的发病率研究不足。本研究旨在评估中国HF患者中COPD的患病率及其临床相关性。

方法

对中国心力衰竭研究中2008例HF患者的人口统计学和临床资料进行分析。分为233例COPD病例和1775例非COPD对照,通过多变量逻辑回归确定与HF中COPD发病相关的因素,并深入研究组间临床差异。

结果

HF患者中COPD的发病率为11.60%(233/2008)。COPD亚组中60岁以上个体和男性的比例更高,同时收缩压(SBP)、体重指数(BMI)较低,Charlson合并症指数(CCI)得分较高,PaCO₂水平升高(P<0.05)。II型呼吸衰竭和右心室功能障碍(RVD)在COPD亚组中更为普遍(P<0.001)。调整后的二元逻辑回归表明,COPD与60岁以上年龄(OR = 3.831,95%CI:1.085 - 13.526,P = 0.037)、男性(OR = 1.587,95%CI:1.032 - 2.441,P = 0.036)、较高的CCI(OR = 2.214,95%CI:1.796 - 2.729,P<0.001)、升高的PaCO(OR = 1.035,95%CI:1.015 - 1.055,P<0.001)和RVD(OR = 0.605,95%CI:0.119 - 3.063,P = 0.544)呈正相关。相反,较高的SBP(OR = 0.990,95%CI:0.982 - 0.998,P = 0.020)和log(甘油三酯)(OR = 0.183,95%CI:0.064 - 0.552,P = 0.002)与HF患者的COPD呈负相关。

结论

在一大群中国心力衰竭(HF)患者中,我们的研究显示COPD患病率显著。主要危险因素包括年龄、性别、升高的PaCO、CCI评分和右心衰竭,而较高的SBP和甘油三酯水平具有保护作用。这些见解为探索疾病机制和治疗方法奠定了基础。

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