Our study identified lower left ventricular ejection fraction and lower hemoglobin level along with older age, lower BMI, and lower FEV1 as independent risk factors for the mortality of COPD patients.
Our data suggest that multidisciplinary approaches are required in the care of CAD in COPD patients because male gender, hypertension, left heart failure, and lower serum HDL level were independent predictors for the presence of CAD in COPD.
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１６ - 국문요약 -
관상동맥질환을 동반한 만성폐쇄성폐질환 환자의 임상적 특징에 대한 연구
아주대학교 대학원의학과 안 영 환
(지도교수 : 박 주 헌)
배경 : 관상동맥질환은 만성폐쇄성폐질환 환자에게서 흔히 동반되는 질환이며, 심혈관 계사망은 만성폐쇄성폐질환 환자의 주요 사망원인 중 하나로 알려져 있다. 따라서 만성 폐쇄성폐질환 환자에게서 관상동맥질환과 연관된 예후 인자를 찾고, 만성폐쇄성폐질환 환자의 사망에 영향을 미치는 독립인자들을 규명하고자 본 연구를 시행하였다.
방법 : 2000년 1월부터 2012년 12월까지 아주대병원 호흡기내과에 방문하여, 폐기능 검사를 통해 만성폐쇄성폐질환이 확정된 환자 중, 관상동맥 CT검사와 관상동맥 조영술 을 통해 관상동맥질환의 유무가 확인된 405명의 환자를 대상으로, 관상동맥질환을 동반 한 군과 동반하지 않은 군으로 나누어 후향적 연구를 진행하였다.
결과 : 남성, 고혈압, 좌심실부전, 낮은 헤모글로빈 수치와 HDL 수치가 만성폐쇄성폐 질환 환자의 관상동맥질환 동반여부와 관련이 있는 독립인자들로 확인되었다(p<0.05).
고령, 낮은 BMI 수치, 낮은 좌심실 박출계수, 낮은 FEV1, 낮은 헤모글로빈 수치가 만성 폐쇄성폐질환 환자의 높은 사망률과 관련된 독립인자들이다(p<0.05).
결론 : 본 연구에서 고령, 낮은 BMI 수치, 낮은 좌심실 박출계수, 낮은 FEV1, 낮은 헤모글로빈 수치가 만성폐쇄성폐질환 환자의 높은 사망률과 관련된 독립인자들이었고, 남성, 고혈압, 좌심실부전, 낮은 헤모글로빈 수치, 낮은 HDL 수치가 만성폐쇄성폐질환 환자의 관상동맥질환 동반과 관련된 독립인자들이었다. 따라서 관상동맥질환을 동반한 만성폐쇄성폐질환 환자를 치료할 때 여러 동반 질환에 대한 관리가 필요한 것으로 사료 된다.
핵심어 : 만성폐쇄성폐질환, 관상동맥질환, 사망률