第一秒用力呼气容积联合BODE评分对慢性阻塞性肺疾病合并肺结核患者预后的预测价值  

The predictive value of FEV1combined with BODE score in the short-term prognosis to patients with COPD and pulmonary tuberculosis

作　　者：包蕾 王永 刘亚玲 罗川 黄文亭 BAO Lei;WANG Yong;LIU Ya-Ling;LUO Chuan;HUANG Wen-Ting(The Chengdu Public Health Clinical Medical Center,Chengdu 610000,China)

机构地区：[1]成都市公共卫生临床医疗中心,成都610000

出　　处：《内科急危重症杂志》2019年第1期41-44,共4页Journal of Critical Care In Internal Medicine

摘　　要：目的:分析第一秒用力呼气容积(FEV_1)联合BODE评分对慢性阻塞性肺疾病(COPD)合并肺结核患者预后结局的预测价值。方法:选择84例慢性阻塞性肺疾病(COPD)患者,按是否合并肺结核分为COPD组45例、COPD并肺结核组39例。分别检测并比较2组的FEV_1、FEV_1/FVC即FEV_1/用力肺活量(FVC)、最大呼气中断流量(MMEF)、最大通气量(MVV)、肺总量(TLC)、肺CO弥散量(DLCO)、单位肺泡CO弥散量(DLCO/VA)、残气量(RV)及BODE评分的差异。随访1年,依据预后情况分为良好组和严重组,比较两亚组上述指标的差异。应用Pearson直线回归分析肺功能指标及BODE评分与预后不良事件发生率的相关性,再用多元Logistic回归分析上述指标与预后结局的相关性。结果:与COPD组比较,COPD并肺结核组患者FEV_1、FEV_1/FVC、MMEF、FVC、DLCO及DLCO/VA均较低(均P<0.05),而TLC及RV均较高(均P<0.05)。COPD并肺结核组患者BODE评分显著高于COPD组(P<0.05)。随访1年,严重组患者FEV_1、FEV_1/FVC显著低于良好组(均P<0.05),而BODE评分高于良好组(P<0.05)。RV及BODE评分与预后不良事件发生率正相关(P<0.05),而与FEV_1、FEV_1/FVC及MMEF负相关(均P<0.05)。多元Logistic回归分析,FEV_1及BODE评分是COPD合并肺结核患者预后结局独立危险因素(OR=4.925,3.256,均P<0.05)。结论:FEV_1联合BODE评分能有效预测COPD合并肺结核患者短期预后。Objective:To analyze the predictive value of forced expiratory volume in one second(FEV1)combined with BODE score in the short-term prognosis to patients with chronic obstructive pulmonary disease(COPD)and pulmonary tuberculosis.Methods:Eighty-four patients diagnosed as having COPD were collected and divided into two groups:COPD group(45 cases)and combination group(39 cases).The values of FEV1,FEV1/FVC,maximal expiratory flow(MMEF),maximal ventilatory volume(MVV),total lung capacity(TLC),diffusion capacity for carbon monoxide of lung(DLCO),DLCO/VA,residual volume(RV)and BODE score were detected and compared between two groups.During the follow-up period of one year,all patients were divided into two sub-groups according to the outcome of prognosis:fine subgroup and serious subgroup.The above indexes were also compared between two subgroups.The relationships of the above indexes with the outcome of prognosis were analyzed by Pearson linear regression and multivariate Logistic regression analysis.Results:Compared to the COPD group,the values of FEV1,FEV1/FVC,MMEF,FVC,DLCO and DLCO/VA in combination group were significantly reduced(P<0.05),and those of TLC and RV were significantly increased(P<0.05).The BODE scores in combination group were significantly higher than in COPD group(P<0.05).During the rollow-up period of one year,the values of FEV1 and FEV1/FVC in serious subgroup were significantly lower(P<0.05),and BODE score significantly higher than in fine subgroup(P<0.05).The RV and BODE score had a positive relationship with the outcome of prognosis(P<0.05),and the FEV1,FEV1/FVC and MMEF had a negative relationship with the outcome of prognosis(P<0.05).The multivariate Logistic regression analysis revealed that the FEV1 and BODE score were the risk factors for the outcome of prognosis(OR=4.925,P=0.028;OR=3.256,P=0.031).Conclusion:The FEV1 combined with BODE score can efficiently predict the short-term prognosis to patients with COPD and pulmonary tuberculosis.

关 键 词：第一秒用力呼气容积 BODE评分 慢性阻塞性肺疾病 肺结核 预后 

分 类 号：R563[医药卫生—呼吸系统] R521[医药卫生—内科学]