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目的探讨慢性阻塞性肺疾病患者左心结构改变情况。方法将158例慢阻肺患者分为A、B、C、D四组,同时对所有患者的左心结构,即:左心房横径、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室舒张末期容积(LVEDV)和二尖瓣口舒张早期峰值流速/二尖瓣口舒张晚期峰值流速(E/A)等进行测定,且A、B、C、D组分别与30例血气分析与通气功能正常的人的左心结构进行比较。结果(1)左房横径:D组相对于对照组、A组及B组呈显著性降低,P<0.05。(2)LVEDD、LVEDV:C、D两组分别较A、B、对照呈显著性降低,P<0.05。肺动脉高压组较非肺动脉高压组和对照组呈显著性降低,P<0.05。(3)E/A值:对照组分别较B、C、D组E/A值呈显著降低,P<0.01;C组较A组E/A值呈显著性降低,P值<0.05。肺动脉高压组较非肺动脉高压组和对照组呈显著性降低,P<0.05。结论气流阻塞可以引起左心室舒张功能下降,且E/A比值与FEV%post之间呈正相关。
Objective To investigate the left ventricular structural changes in patients with chronic obstructive pulmonary disease. Methods 158 COPD patients were divided into four groups: A, B, C and D, and their left ventricular structures, including left atrial diameter, left ventricular end diastolic dimension (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic volume (LVEDV) and mitral early diastolic peak flow velocity / mitral peak diastolic peak flow velocity (E / A) were measured, and A, B, 30 cases of blood gas analysis and ventilation normal left ventricular structure were compared. Results (1) Left atrial diameter: group D compared with the control group, group A and group B was significantly reduced, P <0.05. (2) LVEDD, LVEDV: C, D groups were significantly lower than A, B, control, P <0.05. Pulmonary hypertension group was significantly lower than non-pulmonary hypertension group and control group, P <0.05. (3) E / A value: Compared with B, C, D group, the E / A value of the control group decreased significantly (P <0.01); the E / A value of the C group was significantly lower than that of the A group (P <0.05). Pulmonary hypertension group was significantly lower than non-pulmonary hypertension group and control group, P <0.05. Conclusions Airflow obstruction can cause the decrease of left ventricular diastolic function, and there is a positive correlation between E / A ratio and FEV% post.