摘要
目的观察额面P波电轴与慢性阻塞性肺疾病(COPD)患者疾病严重程度及预后评估体系的相关性。方法连续性选取2022年1月至7月在湖南省胸科医院门诊随访的年龄>45岁的COPD患者为研究对象;同期于本院健康体检的人员为对照组。二组受试者均完成心电图和肺功能检查,并计算COPD组的BODE指数。记录研究对象的额面P波电轴水平及肺功能检查结果,比较COPD组和对照组之间额面P波电轴的差异,明确额面P波电轴在COPD的诊断、病情严重程度判断及预后评估中的价值。结果COPD组第1秒用力呼气容积/用力肺活量(FEV1/FVC)水平显著低于对照组,而P波电轴水平显著高于对照组,差异均有统计学意义(均P<0.05)。绘制受试者工作特征(ROC)曲线发现P波电轴预测诊断COPD的AUC=0.96(P<0.01),最佳截断点为63.80,灵敏度为0.89,特异度为0.93。按照气流受限程度进行分组发现,各亚组间P波电轴水平、第1秒用力呼气容积占预计值百分比(FEV1%pred)、BMI及BODE指数差异有统计学意义(均P<0.05)。相关性分析显示,P波电轴水平与BODE指数呈正相关(r=0.77,P<0.01),与肺功能FEV1%pred呈负相关(r=-0.76,P<0.01)。结论额面P波电轴水平与COPD的病情严重程度及预后评估体系有较好的相关性,具有临床应用价值。
Objective To observe the correlation between the frontal P-wave axis and the severity of chronic obstructive pulmonary disease(COPD)and the prognosis evaluation system.Methods Patients with COPD>45 years old who were followed up in the outpatient department of Hunan Chest Hospital from January to July 2022 were continuously selected as subjects.At the same time,the healthy people who examined in the health management center of our hospital were in the control group.Both groups of subjects completed electrocardiogram and pulmonary function tests.The level of frontal P-wave axis and the results of pulmonary function examination were recorded,and the differences of frontal P-wave axis between the COPD group and the control group were compared,so as to clarify the value of frontal P-wave axis in the diagnosis,disease severity and prognosis evaluation of COPD.Results The level of forced expiratory volume in the first second/forced vital capacity(FEV1/FVC)in the COPD group was significantly lower than that in the control group,while the level of P-wave axis was significantly higher than that in the control group(all P<0.05).The receiver operating characteristic(ROC)curve of P-wave axis showed that the AUC of P-wave axis in predicting COPD was 0.96(P<0.001),the best cut-off value was 63.80,the sensitivity was 0.89,and the specificity was 0.93.There were significant difference in P-wave axis level,the forced expiratory volume in one second to forced vital capacity ratio(FEV1%pred),body mass index(BMI)and BMI,airflow obstruction,dyspnea,and exercise capacity(BODE)index between groups according to the degree of airflow limitation(all P<0.05).Correlation analysis showed that P-wave axis level was positively correlated with BODE index(r=0.77,P<0.001),and negatively correlated with pulmonary function FEV1%pred(r=-0.76,P<0.001).Conclusions There is a good correlation between the level of frontal P-wave axis and the severity of COPD and the prognosis evaluation system,which has clinical application value.
作者
李湘玉
王春婷
乐星
李雅琪
李扬帆
Li Xiangyu;Wang Chunting;Le Xing;Li Yaqi;Li Yangfan(Department of Electrophysiology,Hunan Chest Hospital,Changsha 410006,China)
出处
《中国医师杂志》
CAS
2023年第3期365-369,共5页
Journal of Chinese Physician
基金
湖南省结核病防治所科研项目(SXK2022008)。
关键词
肺疾病
慢性阻塞性
心电描记术
呼吸功能试验
Pulmonary disease,chronic obstructive
Electrocardiography
Respiratory function tests
作者简介
通信作者:王春婷,Email:382818713@qq.com。
