Study Of PWV ABI In Elderly COPD Patients

Objective:To explore the level of Pulse wave velocity and Ankle Brachial Index in elderly patients with COPD. To analyze the relations of age, smoking, pulmonary function, inflammatory factor, and PWV、ABI in elderly patients with COPD.Method:1. Collecting general datas of109cases research object to meet the criteria2. Pulmonary function tests for all the research object, according to the result research object is divided into three groups:mild-to-moderate COPD group (FEV1%50%or higher)(n=41), severe and very severe COPD group (FEV1%<50%)(n=32) and control group without COPD (n=36).3. hs-CRP,11-6, and TNF-a were detected on all the research object.4. PWV\ABI are measured on all the research subjects.5Contrasted PWV, ABI, pulmonary function and inflammatory factor among the three groups, to analyze the relations between PWV and age, smoking, pulmonary function and inflammatory factor.Result:1.(1)There were not statistically significant differences on age, gender, BMI, heart rate, systolic pressure, diastolic blood pressure, fasting plasma glucose, LDLand creatinine in three groups(P>0.05).(2)Smoking:Contrasted with the control group(47.2%), mild-to-moderate COPD group (76.2%), severe and very severe COPD group (74.2%) were increased significantly, the differences were significant statistically significance (P<0.01); In the severe and very severe COPD group and mild-to-moderate COPD group, smoking rate has no statistically significance differences (P>0.05).2.(1) The severe and very severe COPD group and mild-to-moderate COPD group compared with the control group respectively, the FEV1:FVC ratio、percent predicted FEV1is lower than the control group, the differences were significant statistical significance (P<0.01), The FEV1:FVC ratio and percent predicted FEV1 of severe and very severe COPD group were lower than mild-to-moderate COPD group, the differences were significant statistical significance (P<0.01).(2) Compared with the average PWV (1389.25±209.42cm/s) of control group on, the average PWV (1762.02±265.72cm/s) of severe and very severe COPD group and the average PWV (1559.53±185.62cm/s) of mild-to-moderate COPD group were higher than control group, the differences were significant statistical significance (P<0.01), the average PWV (1559.53±185.62cm/s) of mild-to-moderate COPD group was lower than the average PWV (1762.02±265.72cm/s) of severe and very severe COPD group, the differences were significant statistical significance (P<0.01). ABI (3) the left side of ABI, the right side of ABI, average ABI had no statistical significance difference in three groups (P>0.05).(4) Compared with control group, the levels of hs-CRP、 TNF-a,11-6in two COPD groups are higher than in the control group, the differences were significant statistical significance (P<0.01), the levels of hs-CRP、TNF-a Il-6in mild-to-moderate COPD group is lower than in severe and very severe COPD group, the difference was statistically significant (P<0.05).3. Comparison of general clinical data, PWV, ABI in smoker of COPD patients group and smokers of control group:(1) There were not statistically significant differences on age, gender, BMI, heart rate, systolic pressure, diastolic blood pressure, fasting plasma glucose, LDLand creatinine in two groups(P>0.05).(2) the average PWV (1630.29±211.47cm/s) of smoker of COPD patients group higher than the average PWV (1379.82±220.67cm/s) of smokers of control group COPD group, the differences were significant statistical significance (P<0.01),(3) the average ABI (1.04±0.11) of smoker of COPD patients group compared to the average ABI (1.07±0.10) of smokers of control group,there was no statistically significant difference (P>0.05).4. The average PWV (1357.05±146.10cm/s) of60to69age group is lower than the average PWV (1520.56±218.98cm/s) of70to79age group, the difference was statistically significant (P<0.05), The average PWV of60to69age group is lower than the average PWV (1631.16±261.98cm/s) of above80years old group, the differences were significant statistical significance (P<0.01), the average PWV of70 to79age group is lower than the average PWV of above80years old group, the difference was statistically significant (P<0.05).5. Correlation analysis:(1) the age was positively correlated with average PWV (r=0.427, P<0.001).(2) between smoking and average PWV were no correlation relationship (P=0.538).(3) the FEV1:FVC ratio was negatively correlated with the average PWV (r=0.534, P<0.001).(4) the percent predicted FEV1was negatively correlated with the average PWV (r=0.515, P<0.001).(5) the hs-CRP was positively correlated with the average PWV (r=0.675, P<0.001).(6) the TNF-a was positively correlated with average PWV (r=0.620, P<0.001).(7) the IL-6was positively correlated with average PWV (r=0.678, P<0.001).(8) the hs-CRP、 TNF-a、IL-6were was positively correlated with the percent predicted FEV1(r=-0.384、-0.510、-0.427, P<0.001)Conclusions:1. The arterial stiffness of elderly COPD patients increased significantly than in the control group, the PWV was positively correlated with the severity of airway obstruction.2. There is an obvious correlation between age and arterial stiffness, arterial stiffness increases with ageing.3. Two groups of COPD have similar smoking rates, but have different PWV, severe and very severe COPD groups increased significantly; The PWV of smokers in COPD group was obviously higher than smokers in control group:The regression analysis of smoking rates and PWV also suggest that there is no correlation between smoking rates and PWV.4. There is an correlation between inflammatory cytokines and PWV, inflammatory cytokines may be one effect of arterial stiffness increased in COPD patients.