Stabil Kronik Obstrüktif Akciğer Hastalığı Olan Hastalarda Klinik Parametreler ve İnflamasyon Belirteçlerinin Pulmoner Hipertansiyon ile İlişkisi

Abstract

Amaç: Kronik obstrüktif akciğer hastalığı (KOAH), tamamen geri dönüşümlü olmayan ilerleyici hava akımı kısıtlaması ile karakterizedir. Bu çalışmada, KOAH hastalarında hastalık şiddeti parametreleri ve inflamasyonun PAP ile ilişkisini araştırdık. Gereç ve Yöntemler: Kırıkkale Üniversitesi Tıp Fakültesi Göğüs Hastalıkları Anabilim Dalı polikliniğinde tedavi görmekte olan 80 KOAH'lı hasta grubu ile uyumlu 46 kişilik kontrol grubu çalışmaya dahil edildi. Spirometri ölçümleri yapıldı (FEV1, FVC, FEV1 / FVC, MEF ve PEF). Kardiyoloji Anabilim Dalı polikliniğinde sistolik Pulmoner Arter Basıncı (sPAP) ölçümleri ve standart doppler ekokardiyografi yapıldı. Bulgular: CRP stabil KOAH'lı hastalarda kontrol grubuna göre anlamlı olarak yüksek bulundu. KOAH hastalarının sPAP değerleri kontrol grubuna göre anlamlı derecede yüksekti. Yaş, cinsiyet ve VKİ değerleri dikkate alınarak sPAP ile Modifiye Kümülatif Hastalık Derecelendirme Ölçeği (MCIRS) puanı ile FVC% arasındaki ilişki lineer regresyon analizi ile değerlendirildi. SPAP değeri ile yaş arasında istatistiksel olarak anlamlı pozitif bir ilişki gözlendi (p=0,006). SPAP ve MCIRS skoru arasında istatistiksel olarak anlamlı bir ilişki yoktu (p=0,700). SPAP ile FVC% arasında istatistiksel olarak zayıf bir negatif ilişki gözlendi (p=0,053) Sonuç: PAH gelişimi KOAH hastalarında morbidite ve mortaliteyi artırmaktadır. Bu nedenle KOAH'ın ileri evrelerinde olan hastalar, PAH gelişimini kontrol etmek için kullanımı kolay, hızlı ve tekrarlanabilir bir ölçüm yöntemi olan ekokardiyografi ile taranmalıdır.

Keywords

• Kronik obstrüktif akciğer hastalığı
• inflamasyon
• pulmoner hipertansiyon

Relationship of Clinical Parameters and Inflammation Markers with Pulmonary Hypertension in Patients with Stable Chronic Obstructive Pulmonary Disease

Abstract

Aim: Inflammation is an important mechanism in the development of pulmonary arterial hypertension (PAH) in patients with COPD. In this study, we investigated the relationship of disease severity parameters and inflammation with PAP in COPD patients. Material and Methods: A patient group consisting of 80 patients with stable COPD including who were obtaining treatment at the outpatient clinic of Kırıkkale University Faculty of Medicine Department of Pulmonary Medicine were included in the study along with a control group of 46 individuals who were compatible with the patient group in terms of age and gender and did not have any airway obstruction. Spirometry measurements were performed (FEV1, FVC, FEV1/FVC, MEF and PEF). Systolic pulmonary artery pressure (sPAP) measurements and standard doppler echocardiography were performed at the outpatient clinic of the department of cardiology. Results: CRP was found to be significantly higher in patients with stable COPD compared to the control group. sPAP values of COPD patients were significantly higher than those of the control group. A statistically significant positive relationship was observed between the sPAP value and age (p = 0.006). There was no statistically significant relationship between sPAP and MCIRS score (p = 0.700). A statistically weak negative relationship was observed between sPAP and FVC% (p = 0.053) Conclusion: Development of PAH increases morbidity and mortality. Therefore, patients with advanced stages of COPD should be screened using echocardiography, which is an easy-to-use, fast and repeatable measurement method to check for PAH development.

Keywords

• Chronic obstructive pulmonary disease
• inflammation
• pulmonary arterial hypertension

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