Clinical Analysis Of Chronic Obstructive Pulmonary Disease With Cardiovascular Disease

Objective:To study the risk factors and the clinical characteristics of chronic obstructive pulmonary disease(COPD)with cardiovascular disease,improve the COPD patients with cardiovascular disease clinical diagnosis consciousness,timely diagnosis and treatment to improve the prognosis.Methods:This is a retrospective clinical control study.The patients were selected from July2014 to July 2016 in our hospital,102 cases were hospitalized in Department of Cardiology and Respiratory Medicine.They were grouped as the followings:simple COPD in 30 cases,COPD with coronary heart disease(CHD)in 22 cases,chronic pulmonary heart disease(PHD)in 24 cases,PHD with CHD in 26 cases.Compared the differents of risk factors(including smoking history,hypertension,diabetes mellitus,hyperlipidemia),BNP,hs-TnI,arterial blood gas analysis,ECG,between COPD and CHD,COPD and PHD,PHD and CHD.The correlation analysis were used to identify significant relationships between PaO2 and cardiac markers.Results:1.Risk factors:The hypertension,diabetes mellitus,hyperlipidemia in COPD+CHD group were higher than simple COPD group(P<0.05).The history of heart failure in PHD group were higer than COPD group(P<0.05).The hypertension,diabetes mellitus,hyperlipidemia,The history of heart failurein PHD+CHD group were higher than PHD group(P<0.05).2.Comparison of plasma BNP levels:The PHD group was higher than COPD group(P<0.01),the PHD+CHD group was higher than PHD group(P<0.05).3.Comparison of plasma hs-TnI levels:The PHD group was significantly higher than COPD group(P<0.01).4.Arterial blood gas analysis:The result of PaO2 in PHD group was lower thanCOPD group(P<0.001),the level of PaCO2 was higer than COPD group(P<0.05).5.ECG:The incidence rate of ST-T change of ECG in COPD+CHD group was higher than COPD group(P<0.05),the incidence rate of limb lead low voltage,electric axis clockwise rotation,right ventricular hypertrophy,atrial premature beats of ECG in PHD group was higher than COPD group(P<0.05),the incidence rate of left bundle branch block,atrioventricular block,persistent ST-T change,persistent atrial fibrillation of ECG in PHD+CHD group was higher than PHD group(P<0.05).6.In the PHD group,there was a negative correlation between PaO2 and plasmal BNP(r=-0.429,P=0.037<0.05),there was no correlation between PaO2 and plasmal hs-TnI(P>0.05).Conclusions:1When COPD or PHD patients with hypertension,diabetes,hyperlipidemia,the CHD is more likely to occur.2.The level of BNP in PHD group was higher than COPD group,and the level of BNP in PHD+CHD group was higer than PHD group,the level of BNP in the patients with PHD and PHD combined with CHD in the identification of positive significance.3.When the clinical symptoms of COPD or PHD patients become more serious,according to the complications of patients,the level of BNP,the level of hs-TnI,ECG and other conditions,these patients have a high probability of complicated with CHD.The next we should arrange the coronary arteriongraphy.