| ObjectiveChronic obstructive pulmonary disease(COPD)is a common respiratory disease characterized by persistent respiratory symptoms and restricted airflow,often associated with cardiovascular diseases such as coronary heart disease.Peripheral arterial disease(PAD)is an equal risk of coronary heart disease,and peripheral arterial disease is closely related to arteriosclerosis.In recent years,foreign literature reports that the prevalence of PAD in patients with COPD is significantly higher than that in patients without COPD,and patients with PAD have no PAD symptoms,but there are few reports in China.The purpose of this study was to understand the condition of arteriosclerosis and PAD in patients with chronic obstructive pulmonary disease,to explore the related factors of arteriosclerosis,and to provide an objective basis for the early prevention and treatment of PAD in patients with chronic obstructive pulmonary disease,and to explore whether peripheral arterial blood flow testing methods can help Assessment of arteriosclerosisMethodAccording to the standard of admission,84 patients with stable phase of chronic obstructive pulmonary disease were selected from the outpatient clinic of the First Affiliated Hospital of China Medical University from July 20 to 2018.The chronic obstructive pulmonary disease was developed according to the 2018 Global Initiative for Chronic Obstructive Pulmonary Disease(GOLD).The diagnostic criteria were diagnosed in 59 males and 25 females,including 14 cases of GOLD I,51 cases of GOLD II,16 cases of GOLD III,and 3 cases of GOLD IV Based on the collection of patient demographic data,the Chronic Obstructive Pulmonary Disease Assessment Test(CAT)score and the modified British Medical Research Council Questionnaire(mMRC)score were used to measure blood pressure,peripheral oxygen saturation,body fat percentage,and six-minute walk,distance.The OMROM BP-203RPE III arteriosclerosis detector was used to detect arteriosclerosis related indicators,including bilateral pulse wave velocity(baPWV),ankle brachial index(ABI),and toe-arm index(TBI).When ABI<0.9,the diagnosis was PAD Arteriosclerosis was determined when baPWV>1400cm/s.Patients were divided into arteriosclerosis group and arteriosclerosis-free group according to whether the patient had arteriosclerosis.The iu22 ultrasonic diagnostic apparatus was used to detect the peak flow velocity(PeakV)and blood flow acceleration(AccV)of the bilateral iliac artery and dorsal artery systolic ascending branch,and to explore the significance of peripheral arterial ultrasound blood flow detection to help determine arteriosclerosis.Result1.Arteriosclerosis and peripheral arterial disease in patients with chronic obstructive pulmonary diseaseOf the 84 patients with chronic obstructive pulmonary disease,65(77.4%)with arteriosclerosis and 5(5.95%)had peripheral arterial disease.Compared with patients with chronic obstructive pulmonary disease without arteriosclerosis,patients with chronic obstructive pulmonary atherosclerosis were older(P<0.01),higher BMI and body fat percentage(P<0.05).FVC and FEVi decreased more significantly before inhalation of bronchodilator(before inhalation)and after inhalation of bronchodilator(after drug administration)(P<0.05).2.Correlation between arteriosclerosis index and pulmonary function index in patients with chronic obstructive pulmonary diseaseLinear correlation analysis showed that bilateral baPWV in patients with COPD was positively correlated with age(left r=0.493,right r=0.438,P<0.01),and negatively correlated with FEVi before and after drug administration(left side)Before and after inhalation,r=-0.260,r=-0.272,P<0.05;before and after drug inhalation,r=-0.216,r=-0.231,P<0.05,respectively,and drug absorption.Post-FEVi/FVC was also negatively correlated(r=-0.228 on the left,r=-0.261 on the right,P<0.05),suggesting that arteriosclerosis in patients with COPD is associated with airflow limitation.3.Correlation between ABI and pulmonary function indexes in patients with chronic obstructive pulmonary diseaseLinear correlation analysis showed that bilateral ABI reflecting peripheral arterial occlusion was positively correlated with FEVi/FVC before and after drug administration(r=0.241,r=0.257,P<0.05,before and after left drug inhalation,respectively;P right<0.05;Before drug aspiration r=0.295,and after drug aspiration r=0.278,P<0.05,respectively,further suggest that the occurrence of peripheral arterial disease in patients with chronic obstructive pulmonary disease may be related to the degree of airflow limitation4.Correlation between arteriosclerosis index and peripheral arterial AccV and PeakV in patients with chronic obstructive pulmonary diseaseUltrasound examination of blood flow in peripheral arteries(including bilateral radial artery and bilateral dorsal artery)did not reveal significant differences between the two groups of chronic obstructive pulmonary disease patients(including AccV and PeakV)(P>0.05).Linear correlation analysis showed that the left side of the patient's baPWV was positively correlated with the left and right radial artery AccV(left r=0.248,right r=0.337,P<0.05),and the right baPWV was only positively correlated with the right radial artery AccV(r=0.316,P<0.01),bilateral ABI and ultrasound-detected peripheral arteries AccV and PeakV were not significantly correlated,suggesting that ultrasound detection of peripheral arterial AccV and PeakV has limited value in the evaluation of arteriosclerosisConclusion1.The proportion of patients with arteriosclerosis in patients with chronic obstructive pulmonary disease was higher(77.4%),and those with peripheral arterial disease accounted for 5.95%;2.Arteriosclerosis in patients with chronic obstructive pulmonary disease is related to airflow limitation in addition to age;3.Ultrasound detection of radial artery AccV has a certain correlation with the index baPWV reflecting arteriosclerosis,but the value of evaluating arteriosclerosis remains to be further explored. |
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