肾损伤对慢性阻塞性肺疾病急性加重及住院的影响

摘要

Objective To investigate the influence of chronic renal disease (CKD) on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and hospitalization.Methods Fifty patients clinically diagnosed as COPD complicating CKD in our hospital from January 2011 to June 2013 were selected as the observation group and 50 patients with CKD-free COPD were taken as a control group.The comparative analysis was performed by retrospecting the data of lung function,exercise tolerance and hospitalization situation in 1 year follow up.Results The mortality rate,total occurrence rate of AECOPD,occurrence rate of severe AECOPD,hospitalization rate,hospitalization time,self-rating test (CAT) score,mMRC dyspnea index,CRP and blood creatinine level in the observation group were higher than those in the control group,the difference was statistically significant (P<0.05);FEV1%pred,6MWD and creatinine clearance rate in the observation group were lower than those in the control group,the difference was statistically significant (P<0.05);FEV1/FVC had no statistical difference between the two groups (P>0.05).Conclusion The condition in COPD patients complicating CKD at 1 year after clinical diagnosis is significantly aggravated compared with COPD patients without complicating CKD,and the prognosis for patients complicated with CKD is poorer.%目的 探讨慢性肾脏病(CKD)对慢性阻塞性肺疾病(COPD)急性加重(AECOPD)及住院的影响.方法 选取2011年1月至2013年6月该院经临床确诊的COPD合并CKD患者50例(观察组),及未合并CKD的COPD患者50例(对照组).回顾性分析患者1年内的肺功能、运动耐力及住院情况等资料,并进行比较.结果 观察组病死率、AECOPD总发生率及重度AECOPD发生率、住院率、住院时间、自我评估测试(CAT)评分、改良英国医学研究理事会(mMRC)呼吸困难指数、C反应蛋白(CRP)及血肌酐水平均高于对照组,差异均有统计学意义(P<0.05);观察组第1秒用力呼气容积(FEV1)占预计值百分比(FEV1%pred)、6 min步行试验(6MWD)及肌酐清除率均低于对照组,差异均有统计学意义(P<0.05);两组FEV1/用力肺活量(FVC)比值比较,差异无统计学意义(P>0.05).结论 确诊后1年COPD合并CKD患者的病情较未合并CKD患者明显加重,预后较差.