【摘要】 目的探讨吸烟与慢性阻塞性肺疾病患者发生肺动脉高压的相关性。方法选择徐州矿务集团总医院2016年06月至09月,年龄在60-80岁的COPD合并肺动脉高压住院患者61例资料进行分析,分为吸烟组30例,戒烟组22例,不吸烟组19例,均随访6个月,对三组患者治疗及预后情况进行分析。三组患者在入组时均完善超声心动图,肺功能,超敏C-反应蛋白(hs-CRP),血清丙二醛(MDA),超氧化物歧化酶(SOD)。戒烟组,在入组时开始戒烟,在三月内完成戒烟,所有研究对象,在入组后3月时和6月时均随访一次,完善上述指标复查。结果入组时,吸烟组和戒烟组患者MDA、和hs-CRP水平明显高于不吸烟组,而SOD低于不吸烟组,三组比较差异具有统计学意义(P<0.05),吸烟组与戒烟组在入组时上述指标不存在差异。吸烟组30例患者肺动脉增高,肺功能恶化死亡1例,死亡率为3.33%;戒烟组和不吸烟组死亡数为0例。随访3个月时,戒烟组22患者中,2例放弃戒烟,中断随访,其余20例完成戒烟干预。随访6个月时,戒烟组肺动脉高压水平下降,戒烟前后存在明显统计学差异(P<0.05);吸烟组患者,肺动脉压较入组时有下降,具有统计学意义(P<0.05)。三组比较,hs-CRP,MDA水平在吸烟组高于戒烟组和不吸烟组,具有统计学意义(P <0.05)。戒烟组高于不吸烟组,差异不明显(P> 0.05)。SOD在三组比较中,吸烟组低于戒烟组和不吸烟组,具有统计学意义(P<0.05),而戒烟组与不吸烟组两组相当(P> 0.05)。结论吸烟是慢阻肺的独立危险因素,吸烟者发生肺动脉高压的风险程度较不吸烟者重。戒烟可减缓上述损伤,降低肺动脉高压。更多还原

【Abstract】 Objective To investigate relationship between smoking and pulmonary hypertension of COPD patients. Methods Choose data of 61 cases COPD patients with pulmonary hypertension in Xuzhou Mining Group General Hospital from June to September 2016 for analysis. Divide them into smoking group(30 cases), smoking quitting group(22 cases), non-smoking group(19 cases). All cases were followed up for 6 months. Analyze treatment and prognosis of three groups. Examine echocardiography, lung function, high-sensitivity C-reactive protein(hs CRP),serum malondialdehyde(MDA), superoxide dismutase(SOD) in three groups. In smoking quitting group, patients began to quit smoking when joining group,finish smoking quitting within three months. All cases were followed up once 3 months and 6 months after enrollment, reexamine above indicators. Results At time of enrollment, MDA and hs CRP levels in smoking group and smoking quitting group were significantly higher than non-smoking group, while SOD significantly lower than non-smoking group. Comparison difference showed statistical significance between three groups,(P< 0.05). Above indexes showed no difference between smoking group and smoking quitting group at enrollment. Pulmonary artery pressure of 30 cases in smoking group increased, 1 cases died of pulmonary function deterioration, with mortality rate of 3.33%; death cases was 0 in smoking group and non-smoking group. During 3-month follow-up, 2 cases of 22 in smoking quitting group gave up and interrupted follow-up. The rest 20 cases completed intervention of smoking quitting. During follow-up of 6 months, pulmonary hypertension level in smoking quitting group decreased significantly, difference showed statistical significance before and after smoking quitting,(P< 0.05).Pulmonary artery pressurein of smoking group decreased significantly compared with enrollment, with statistical significance(P< 0.05). hs CRP and MDA levels in smoking group were higher than smoking quitting group and nonsmoking group, difference was not significant(P> 0.05). SOD in smoking group was lower than smoking quitting group and non-smoking group, difference was statistical significant(P< 0.05), difference showed no statistically significant between smoking quitting group and non-smoking group(P> 0.05). Conclusion Smoking is an independent risk factor of COPD, smokers have higher pulmonary hypertension risk than nonsmokers. Quitting smoking can reduce above injury and lower pulmonary hypertension.更多还原