AECOPD患者血气指标及炎症因子水平与预后的相关性  

Correlation between Levels of Blood Gas Index,Inflammatory Factors and Prognosis in Patients with AECOPD

作　　者：翁增杰[1] 陈楚鹏[1] 杨海丹 WENG Zengjie;CHEN Chupeng;YANG Haidan(Department of General Medicine, Shantou Central Hospital, Shantou Guangdong 515041, China)

机构地区：[1]汕头市中心医院全科医学科,广东汕头515041

出　　处：《河南医学高等专科学校学报》2021年第3期266-269,共4页Journal of Henan Medical College

摘　　要：目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者血气指标及炎症因子水平与预后的相关性。方法回顾性分析85例AECOPD患者的临床资料,观察其预后情况,将呼吸困难、咳嗽、多痰等临床症状基本消失、病情稳定的患者纳入预后良好组(n=65),将呼吸困难、咳嗽、多痰等临床症状持续存在且疾病反复发作的患者纳入预后不良组(n=20)。分析血气指标及炎症因子水平与预后的相关性。结果随访6个月,预后良好组APACHEⅡ评分为(18.59±5.58)分,预后不良组为(23.57±6.13)分,差异有统计学意义(P<0.05);预后不良组二氧化碳分压(PaCO_(2))、降钙素原(PCT)、超敏C反应蛋白(hs-CRP)水平分别为(74.61±12.36)mmHg(1 mmHg=0.133 kPa)、(3.57±1.18)μg·L^(-1)、(25.13±5.36)mg·L^(-1),均高于预后良好组(58.18±11.53)mmHg、(1.89±0.61)μg·L^(-1)、(17.67±4.59)mg·L^(-1),差异有统计学意义(P<0.05);经Pearson相关性分析发现,APACHEⅡ评分与PaCO_(2)、PCT、hs-CRP水平呈正相关(r>0,P<0.05);绘制受试者操作特征曲线(ROC曲线)发现,PaCO_(2)、PCT、hs-CRP检测用于评估预后的曲线下面积(AUC)分别为0.773、0.852、0.861,均具有一定预测价值。结论PaCO_(2)、PCT、hs-CRP水平与AECOPD患者预后具有相关性,通过检测上述指标,可对患者预后作出准确评估。Objective To investigate the correlation between the levels of blood gas index and inflammatory factors and prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods The clinical data of 85 patients with AECOPD were retrospectively analyzed,and the prognosis was observed.Patients with dyspnea,cough,sputum and other clinical symptoms basically disappeared,and patients with stable disease were included in the good prognosis group(n=65),patients with persistent sputum and other clinical symptoms and recurrent disease were included in the poor prognosis group(n=20).Analyze the correlation between blood gas indexes and inflammatory factor levels and prognosis was analyzed.Results After 6 months of follow-up,the APACHEⅡscore of good prognosis group was(18.59±5.58)points,the poor prognosis group APACHEⅡscore was(23.57±6.13)points,the difference was statistically significant(P<0.05).The levels of partial pressure of carbon dioxide(PaCO_(2)),procalcitonin(PCT),and high sensitivity C-reactive protein(hs-CRP)in the poor prognosis group were(74.61±12.36)mmHg(1 mmHg=0.133 kPa),(3.57±1.18)μg·L^(-1),(25.13±5.36)mg·L^(-1) respectively,which were higher than those in good prognosis group(58.18±11.53)mmHg,(1.89±0.61)μg·L^(-1),(17.67±4.59)mg·L^(-1) respectively,the difference was statistically significant(P<0.05).Pearson correlation analysis showed that ApacheⅡscore was positively correlated with PaCO_(2),PCT and hs-CRP levels(r>0,all P<0.05);the receiver operating characteristic curve(ROC curve)was drawn and showed that AUC of the detection of PaCO_(2),PCT and hs-CRP in evaluating the prognosis were 0.773,0.852 and 0.861,respectively,which had certain predictive value.Conclusion The levels of PaCO_(2),PCT and hs-CRP are significantly correlated with the prognosis of patients with AECOPD.Through the detection of the above indicators,the prognosis of patients can be accurately evaluated.

关 键 词：慢性阻塞性肺疾病 急性加重期 动脉血二氧化碳分压 降钙素原 超敏C反应蛋白 

分 类 号：R563[医药卫生—呼吸系统]