COVID-19 后慢性阻塞性肺病患者临床前动脉硬化的生化预测因素

E. Kulik, V. Pavlenko, S. Naryshkina
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摘要

本文介绍了一项开放性、比较性、前瞻性研究的结果,该研究旨在调查COVID-19康复后的慢性阻塞性肺病(COPD)患者的血管内皮功能状况,并评估长期预测临床前动脉粥样硬化发展的潜力。共有 133 名慢性阻塞性肺病(COPD)患者在门诊条件下接受了检查:主组(90 人)有 COVID-19 病史,对比组(43 人)有 COVID-19 病史。参与者接受了两次检查:V1--感染后 3 周至 3 个月的初次检查,V2--首次就诊 12 个月后的随访检查。根据 V2 点的 CAVI 指数值,主组被分为两个亚组。使用血压计和血液中生化标记物的浓度来评估血管内皮功能状态。与对比组相比,主要组在 V2 点的动脉僵化研究参数(主动脉脉搏波速度、左右心踝关节血管指数(CAVI)、肱动脉和颈动脉增强指数)明显更高。在 V1 点,第一分组(R-CAVI≥8.5 个单位)的内皮素-1、总同型半胱氨酸、单核细胞趋化蛋白、血管内皮生长因子、C 反应蛋白、白细胞介素-6、10 等生物标志物的浓度明显高于第二分组(R-CAVI ˂ 8.5 个单位)。考虑到所获得的结果,我们建立了一个数学模型,用于预测 COPD 患者在 COVID-19 12 个月后的临床前动脉粥样硬化,临床医生可将该模型用于心血管风险的长期评估。
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Biochemical predictors of preclinical arteriosclerosis in patients with chronic obstructive pulmonary disease after COVID-19
This article presents the findings of an open, comparative, prospective study aimed to investigate the state of vascular endothelial function in patients with chronic obstructive pulmonary disease (COPD) who have recovered from COVID-19, and to assess the potential for long-term prediction of preclinical atherosclerosis development.Materials and methods. A total of 133 COPD patients were examined under outpatient conditions: the main group (n=90), with a history of COVID-19, and a comparison group (n=43). Participants were examined twice: V1 - initial examination from 3 weeks to three months post-infection, V2 - a follow-up examination 12 months after the first visit. Based on the CAVI index values at point V2, the main group was divided into 2 subgroups. The state of vascular endothelial function was assessed using volume sphygmomanometry and by determining the concentration of biochemical markers in the blood.Results. In the main group at point V2, the studied parameters of arterial stiffness were significantly higher compared to the comparison group (aortic pulse wave velocity, cardio-ankle vascular index (CAVI) on the right and left, augmentation indices on the brachial and carotid arteries). At point V1, in the 1st subgroup (R-CAVI≥8.5 units), the concentration of biomarkers such as endothelin-1, total homocysteine, monocyte chemoattractant protein, vascular endothelial growth factor, C-reactive protein, interleukin-6,10 was significantly higher than in the 2nd subgroup (R-CAVI<8.5 units). Conclusion. Taking into account the results obtained, a mathematical model for predicting preclinical atherosclerosis in COPD patients 12 months after COVID-19 was developed, which can be applied by clinicians in the long-term assessment of cardiovascular risk. Key words: chronic obstructive pulmonary disease, COVID-19, sphygmomanometry, predictors, prognosis, CAVI index> ˂ 8.5 units).Conclusion. Taking into account the results obtained, a mathematical model for predicting preclinical atherosclerosis in COPD patients 12 months after COVID-19 was developed, which can be applied by clinicians in the long-term assessment of cardiovascular risk.
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