Objectives To analyze the risk factors for cardiovascular disease (CVD) in patients with chronic obstructive pulmonary disease (COPD) of different severities. Methods The study included 50 patients with mild-to-moderate COPD and 50 with severe-to-very severe COPD admitted between January 2014 and January 2016. Comorbidities were recorded on the basis of data obtained from medical charts and clinical evaluations. The Charlson comorbidity index was calculated, and the Hospital Anxiety and Depression Scale (HADS) score was determined in each subject. Results There were more prevalences of smoking, depression and dyslipidemia in the patients with mild-to-moderate COPD than those with severe-to-very severe COPD (all P<0.001). The prevalences of high blood pressure, diabetes mellitus, alcoholism, and chronic heart failure were not different significantly between the two groups. The Charlson comorbidity index and HADS scores were not different between the two groups. Conclusions Comorbidities are fairly common in COPD regardless of its severity. Certain risk factors for CVD, as smoking, dyslipidemia, and depression, appear to be more prevalent in patients with mild-to-moderate COPD.
ObjectivesTo explore the safety and efficacy of beta-blockers (BBs) in patients with chronic obstructive pulmonary disease (COPD) and its effect on prognosis. MethodsThe data of 366 patients with acute exacerbation of COPD in this department were analyzed retrospectively. The use rate and related events of BBs were evaluated, including comorbidity, indications, contraindications and related clinical indicators. ResultsOf the 366 patients, 156 (42.6%) had at least one indication of the use of BBs, but only 53 (34.0%) of these patients used BBs, and 61 patients (39.1%) had no contraindications but did not use BBs. At admission, 72 patients (19.7%) were treated with BBs, 177 (45.6%) with antiplatelet drugs, 145 (39.6%) with statins, and angiotensin converting enzyme inhibitor/angiotensin II receptor blocker was used in 168 (45.9%) patients. Twenty-five patients (6.8%) had ischemic heart disease during hospitalization. Fifty-seven patients (15.6%) had cardiovascular and cerebrovascular events during admission. The patients with cardiovascular and cerebrovascular events had longer hospitalization (P<0.01) and higher in-hospital mortality (P=0.02). ConclusionsPatients with COPD have a clear indication of BBs use, but the clinical use rate is still very low. Further research is needed to explore the prescription disorders of BBs in patients with COPD.
ObjectivesTo investigate the clinical and imaging characteristics of pleural effusion in patients with acute pulmonary embolism (APE).MethodsComputed tomographic pulmonary angiography (CTPA) scans and clinical data of suspected APE patients from January 2014 to December 2018 were analyzed.ResultsA total of 1024 suspected APE patients underwent CTPA examination in the imaging department of our hospital. Two hundred patients (19.5%) were diagnosed with APE. Imaging findings of pleural effusion were revealed in 70 cases (35.0%). The majority of APE patients without pleural effusion were males (82.3% vs. 64.3%, P<0.01), and the majority of APE patients with pleural effusion were females (35.7% vs. 17.7%, P<0.01). Most of the effusions were bilateral, small to moderate, with peripheral embolism (62.9%, P<0.05). Pulmonary consolidation, atelectasis and ground-glass opacity were common manifestations of CTPA. Compared with patients with simple pulmonary embolism, pulmonary embolism with pleural effusion was more common (62.9% and 33.8%, respectively, OR=3.279 and 95%CI 1.798 - 6.091, P<0.001). Diagnostic thoracic puncture was performed in 6 cases (8.6%). Pleural effusion was exudate in these 6 patients, with normal blood sugar and neutrophils predominated.ConclusionsAbout one third of APE patients are associated with pleural effusion, which most presented with small and bilateral pleural effusions. The main embolism associated with pleural effusion is peripheral embolism. There is a significant correlation between pulmonary consolidation and pleural effusion. Pleural effusion is mostly exudate and neutrophils often predominate.