Effect of high altitude on PEF and inflammatory response in elderly patients with heart failure and respiratory tract infection / 公共卫生与预防医学

ABSTRACT

Objective To investigate the effect of high altitude on peak expiratory flow (PEF) in elderly patients with heart failure and respiratory tract infection and its relationship with inflammatory response. Methods A total of 380 elderly patients over 60 years old with heart failure and respiratory tract infection admitted to our hospital from January 2020 to September 2022 were selected by cluster sampling method as research objects, including 190 long-term residents in high-altitude areas and 190 long-term residents in non-high-altitude areas.Information on current diseases, peak expiratory flow (PEF) levels, and inflammatory status (serum TNF) were collected- α， CRP, PCT and IL-6 levels) and other potential influencing factors; The relevant test indexes were collected at the time of enrollment (baseline) and at the time of discharge after treatment (the shortest hospital stay of 6 days and the longest hospital stay of 21 days); To compare the effects of long-term living at high altitude on PEF level and inflammatory state. The study used spss19 0 statistical software package for analysis. Results In this study, 380 elderly patients over 60 years old with heart failure and respiratory tract infection were enrolled, including 190 long-term residents in high-altitude areas (high-altitude group) and 190 long-term residents in non-high-altitude areas (control group). The mean age of patients in the high altitude group was (66.20±6.56) years old, the proportion of male patients was 53.16%, and the proportion of patients with heart failure duration less than 5 years was 70.00%. The average age of the control group was (66.93±6.77) years old, the proportion of male patients was 53.85%, and the proportion of patients with heart failure duration less than 5 years was 71.79%. The levels of PEF, FEV1 and FVC in 2 groups were higher than the baseline level at discharge (t=2.095, 7.139, 11.047, 14.594, 14.104, 12.250, all P<0.05). And the high altitude group was significantly lower than the control group (t=5.260, 6.912, 6.262, P<0.05). The baseline levels of TNF-α, CRP, PCT and IL-6 in the high altitude group were higher than those in the control group. After treatment, the levels of several inflammation-related factors decreased in both groups, but the high altitude group was still higher than the control group. The expression levels of inflammation-related factors (TNF-α, CRP, IL-6, PCT) in subjects at high altitude were negatively correlated with the levels of lung function related indicators (PEF, FEV1, FVC) (r=-0.453, -0.496, -0.379, -0.563, -0.467, -0.522, -0.497, -0.518, -0.419, -0.416, -0.438, -0.480), and the correlation coefficients were statistically significant (P<0.05). Conclusion High altitude living factors are associated with the decrease of PEF. At the same time, it indirectly aggravates the inflammatory state of patients, and it is more difficult for therapeutic intervention to control the inflammation to the ideal level within the same time, which is worthy of clinical attention.