[肺通气障碍在慢性阻塞性肺疾病合并阵发性心房颤动患者心律失常复发发展中的预后意义]。

IF 0.3 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Terapevticheskii Arkhiv Pub Date : 2025-07-31 DOI:10.26442/00403660.2025.07.203296

V I Podzolkov, A I Tarzimanova, E V Kazantseva

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引用次数: 0

摘要

目的：探讨肺通气障碍在慢性阻塞性肺疾病（COPD）合并阵发性心房颤动（AF）患者心律失常复发中的预后价值。材料与方法：研究纳入387例COPD患者，分为两组：1组54例（13.9%）COPD合并阵发性房颤患者，住院期间发生房颤发作；2组（对照组）333例（86.1%）无心律失常的慢性阻塞性肺病患者。结果：1组患者支气管梗阻严重程度明显高于2组。单因素回归分析显示，第1秒强迫呼气量减少少于35%使COPD患者房颤复发风险增加2.49倍(优势比0.401,95%可信区间0.218-0.856；p = 0.012)。体体积描记结果显示，1组患者肺对一氧化碳的弥散能力明显下降，空气动力阻力和支气管比阻力较2组增加，肺弥散能力下降小于8ml /min/mm。汞使COPD患者AF发作风险增加1.297倍(优势比0.771,95%可信区间0.53-0.92；p = 0.013)。为了评估慢性阻塞性肺病和阵发性房颤患者心律失常复发的风险，我们建立了一个数学模型（敏感性- 73.8%，特异性- 70.3%）。结论：肺通气量降低可增加COPD合并阵发性房颤患者心律失常复发的风险。

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[Prognostic significance of pulmonary ventilation disorders in the development of arrhythmia recurrence in patients with chronic obstructive pulmonary disease and paroxysmal atrial fibrillation].

Aim: To evaluate the prognostic value of pulmonary ventilation disorders in the development of arrhythmia recurrence in patients with chronic obstructive pulmonary disease (COPD) and paroxysmal atrial fibrillation (AF).

Materials and methods: The study included 387 patients with COPD, who were divided into two groups: group 1 consisted of 54 (13.9%) patients with COPD and paroxysmal AF, who had AF paroxysm during hospitalization; group 2 (comparison group) - 333 (86.1%) patients with COPD without arrhythmia.

Results: Significantly more severe bronchial obstruction was found in group 1 patients than in group 2 patients. A one-factor regression analysis revealed that a decrease in forced exhalation volume in 1st second of less than 35% increased the risk of AF recurrence in patients with COPD by 2.49 times (odds ratio 0.401, 95% confidence interval 0.218-0.856; p=0.012). According to the results of bodyplethysmography, patients in group 1 showed a significant decrease in the diffusion capacity of the lungs for carbon monoxide, an increase in aerodynamic and specific bronchial resistance compared with group 2, a decrease in the diffusion capacity of the lungs of less than 8 ml/min/mm. Mercury increased the risk of AF paroxysm in COPD patients by 1.297 times (odds ratio 0.771, 95% confidence interval 0.53-0.92; p=0.013). To assess the risk of arrhythmia recurrence in patients with COPD and paroxysmal AF, we developed a mathematical model (sensitivity - 73.8%, specificity - 70.3%).

Conclusion: Decreased ventilation capacity of the lungs increases the risk of arrhythmia recurrence in patients with COPD and paroxysmal AF.

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来源期刊

Terapevticheskii Arkhiv 医学-医学：内科

CiteScore

1.40

自引率

33.30%

发文量

171

审稿时长

3-8 weeks

期刊介绍： Терапевтический архив The journal was founded by the prominent Russian therapists M.P. Konchalovsky and G.F. Lang in 1923. Then its editors-in-chief were Professors V.N. Vinogradov and A.G. Gukasyan. Since 1972, E.I. Chazov, Academician of the Russian Academy of Sciences, has been heading the editorial board of the journal. Over 90 years, there have been more than 1000 issues where the authors and editorial staff have done their best for readers to keep abreast of current advances in medical science and practice and for physicians to master the advanced principles of recognition and treatment of a wide spectrum of visceral diseases. The papers published in the journal (editorials, original articles, lectures, reviews, etc.) cover both current scientific achievements and practical experience in diagnosing, treating, and preventing visceral diseases. The authors of publications are not only Russian, but also foreign scientists and physicians. All papers are peer-reviewed by highly qualified Russian specialists. The journal is published monthly. Traditionally, each issue has predominantly certain thematic areas covering individual therapy specializations. Every year, one of the issues is devoted to related problems in practical medicine (allergology and immunology, neurology and psychiatry, obstetrics, oncology, etc.). This all draws the attention of the reading public to the journal. The journal is indexed in RSCI (Russian Science Citation Index), PubMed/Medline, Index Medicus, Scopus/EMBASE, Web of Science Core Collection (Science Citation Index Expanded), Web of Science (Russian Science Citation Index - RSCI, Current Contents Connect, BIOSIS Previews), Google Scholar, Ulrich''s Periodicals Directory. The journal is included in the list of periodicals recommended by the Higher Attestation Committee for publishing the papers containing the basic materials of doctoral and candidate dissertations. By the decision of the Presidium of the Russian Academy of Medical Sciences, the “Therapevticheskiy Arkhiv” was awarded the Botkin medal. It was admitted to the European Association of Sciences Editors (EASE). The journal was honored with the Golden Press Fund decoration at the 13th International Press Professional Exhibition.