老年冠心病患者下呼吸道感染的发生情况及其对心血管事件发生的影响

Incidence of lower respiratory tract infection and its influence on cardiovascular events in the elderly patients with coronary heart disease

摘要:

目的 观察老年稳定性冠心病患者急性下呼吸道感染的发生率,并分析其对心血管事件发生的影响。方法 选取2015年2月至2017年2月在攀枝花市中心医院老年病科接受治疗的老年稳定性冠心病患者168例为研究对象。依据是否发生下呼吸道感染分为2组:感染组和非感染组。对比2组患者白细胞计数(WBC)、红细胞分布宽度(RDW)、血小板分布宽度(PDW)水平,以及血清脑钠肽(BNP)、左心室射血分数(LVEF)等临床资料。随访6个月,观察2组患者心血管事件发生情况,比较发生心血管事件患者和未发生心血管事件患者肺部感染量表(CPIS)评分的差异。采用SPSS 17.0软件进行数据处理。依据数据类型,组间比较分别采用t检验或χ²检验。结果 168例患者中,合并下呼吸道感染者共68例,占40.48%。感染组患者的WBC[(9.87±0.95)×10⁹/L vs(6.42±0.84)×10⁹/L]、RDW[(13.92±0.98)% vs(13.05±1.02)%]、PDW[(11.78±1.02)% vs(11.01±0.94)%]和BNP[(852.68±9.35) vs(215.71±10.04)pg/ml]均显著高于非感染组,而LVEF水平[(56.49±7.82)% vs(60.02±6.18)%]显著低于非感染组,差异均具有统计学意义(P<0.001)。感染组患者发生心血管事件者25例,未感染组患者发生心血管事件者5例,感染组患者心血管事件发生率高于未感染组(36.76% vs 5.00%,P<0.001)。发生心血管事件患者的CPIS评分显著高于未发生心血管事件者[(1.58±0.23) vs(1.01±0.19),P<0.001]。结论 老年稳定性冠心病患者急性下呼吸道感染发生率较高,合并下呼吸道感染的老年冠心病患者更易发生心血管事件,提示冠心病患者应注意预防下呼吸道感染。

Abstract:

Objective To observe the incidence of acute lower respiratory tract infection and its influence on cardiovascular events in the elderly patients with stable coronary heart disease. Methods The study enrolled 168 elderly patients with stable coronary heart disease who were treated in Panzhihua Central Hospital from February 2015 to February 2017. The patients were divided into infection group and non-infection group according to occurrence of acute lower respiratory tract infection. The two groups were compared in the white blood cell count (WBC), red blood cell distribution width (RDW), platelet distribution width (PDW) level, and serum brain natriuretic peptide (BNP), left ventricular ejection fraction (LVEF) and other clinical data. During the follow-up of 6 months, the two groups were observed for the incidence of cardiovascular events and compared in clinical pulmonary infection scale (CPIS). Data processing was performed using SPSS statistics 17.0. Depending on the data type, Student′s t test or Chi-square test was performed for comparison between groups. Results Among 168 patients, 68(40.48%) were complicated with lower respiratory tract infection. The infection group were significantly higher than the non-infection group in WBC [(9.87±0.95)×10⁹/L vs (6.42±0.84)×10⁹/L] and RDW [(13.92±0.98)% vs (13.05±1.02)%], PDW [(11.78±1.02)% vs (11.01±0.94)%] and BNP [(852.68±9.35) vs (215.71±10.04)pg/ml] but significantly lower in LVEF [(56.49±7.82)% vs(60.02±6.18)%] (P< 0.001). The incidence of cardiovascular events was significantly higher in the infection group than in the non-infection group [36.76%(25/68) vs 5.00%(5/100),P<0.001]. CPIS scores were significantly higher in the patients with cardiovascular events than those without [(1.58±0.23) vs (1.01±0.19), P<0.001]. Conclusion The incidence of acute lower respiratory tract infection is high in elderly patients with stable coronary heart disease, and cardiovascular events are more likely to occur in the patients complicated with lower respiratory tract infection, suggesting that attention should be paid to the prevention of respiratory tract infection in patients with coronary heart disease.