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COPD患者动脉硬化:系统性炎症的作用以及呼吸康复的功效

来源:慢性阻塞性肺病网 手术刀 2014-06-04 |
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摘要:
证明COPD患者的动脉硬化发病率增高;评估系统性炎症与动脉硬化是否有关;研究呼吸康复是否能改善动脉硬化。
COPD患者动脉硬化:系统性炎症的作用以及呼吸康复的功效
COPD患者动脉硬化:系统性炎症的作用以及呼吸康复的功效

    对于COPD患者而言,系统性炎症与动脉硬化发病率增加之间存在关联,目前尚缺乏有效证据。此外,呼吸康复对于动脉硬化是否有改善尚缺乏相关研究。
 
    本研究目的:1、证明COPD患者动脉硬化发病率增高;2、评估系统性炎症与动脉硬化是否有关;3、研究呼吸康复是否能改善动脉硬化。
 
    在呼吸康复开始前,测量168名健康受试者主动脉脉搏波速(APWV),测量162名COPD患者APWV及炎症标记物。最终收集了129名COPD患者呼吸康复后上述指标。
 
    本研究发现与对照组相比,COPD患者APWV显著增加,血压、年龄作为APWV基线预测值,系统性炎症标记物与APWV非独立相关。尽管基线APWV可以预测康复后APWV改变,然而APWV均值并未显著改变(10.7±2.7 versus 10.9±2.5 m.s-1; p=0.339)。
 
    COPD患者动脉硬化系统性炎症无显著相关,先进的呼吸康复治疗对其亦无改善。本研究表明COPD患者合并心血管疾病的高危因素的复杂性以及COPD治疗的复杂性。
 
    ABSTRACT Clear evidence for an association between systemic inflammation and increased arterial stiffness in patients with chronic obstructive pulmonary disease (COPD) is lacking. Moreover, the effects of pulmonary rehabilitation on arterial stiffness are not well studied.
 
    We aimed to 1) confirm increased arterial stiffness in COPD; 2) evaluate its correlates including systemic inflammation; and 3) study whether or not it is influenced by pulmonary rehabilitation.
 
    Aortic pulse-wave velocity (APWV) was determined in 168 healthy volunteers, and APWV and inflammatory markers were determined in 162 COPD patients during baseline evaluation of a pulmonary rehabilitation programme. A complete post-pulmonary rehabilitation dataset was collected in 129 patients.
 
    It was found that APWV was increased in COPD patients when compared with controls, blood pressure and age predicted baseline APWV, and systemic inflammatory markers were not independently related to APWV. Although baseline APWV was predictive for the change in APWV after pulmonary rehabilitation (r5 -0.77), on average APWV did not change (10.7¡2.7 versus 10.9¡2.5 m?s-1; p50.339).
 
    Arterial stiffness in COPD is not related to systemic inflammation and does not respond to state-of-the- art pulmonary rehabilitation. These results emphasise the complexity of cardiovascular risk and its management in COPD.

    文章原标题:Arterial stiffness in patients with COPD: the role of systemic inflammation and the effects of pulmonary rehabilitation

    文章翻译:顾为丽    校正:郑泽广教授

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