超敏CRP对AECOPD合并2型糖尿病患者的预后评估  

HS-CRPAS A PREDICTOR FOR PROGNOSIS IN AECOPDCOMBINED WITH TYPE 2 DIABETES

作　　者：徐伟 XU Wei(Three Gorges Hospital Affiliated to Chongqing University,Wanzhou 404000,China)

机构地区：[1]重庆大学附属三峡医院,重庆市万州区404000

出　　处：《中国煤炭工业医学杂志》2022年第2期157-161,共5页Chinese Journal of Coal Industry Medicine

基　　金：重庆市自然科学基金资助项目(编号:No.cstc2018jcyjAX0469)。

摘　　要：目的探讨超敏CRP(hs-CRP)对AECOPD合并2型糖尿病(T2DM)患者的住院期间不良预后的影响。方法选取2014年1月—2017年12月该院呼吸科收治的AECOPD患者320例,其中AECOPD合并T2DM患者152例,单纯AECOPD患者168例;另选取新诊断的T2DM患者160例和健康体检者150例为正常对照;比较各组一般临床资料、FBG、HbA1c、血清hs-CRP水平等,并应用绘制受试者工作特征曲线(ROC曲线),分析血清hs-CRP水平预测AECOPD合并T2DM患者死亡的临床价值。结果AECOPD合并T2DM患者FBG、HbA1c和血清hs-CRP水平高于单纯AECOPD组、单纯T2DM组和对照组,且差异均有统计学意义(均P<0.05);将AECOPD合并T2DM患者分为死亡组36例和存活组116例,与存活组比较,死亡组患者接受机械通气比例、FBG、HbA1c、血清hs-CRP水平和PaCO_(2)均升高,而PaO_(2)降低,且差异均有统计学意义(均P<0.05);Logistic回归分析提示,接受机械通气比率[OR=2.286(95%CI:1.994~2.876),P=0.021]、HbA1c[OR=2.615(95%CI:1.545~3.763),P=0.008]、血清hs-CRP水平[OR=2.846(95%CI:1.524~4.279),P=0.009]和PaCO_(2)[OR=1.984(95%CI:1.358~2.993),P=0.018]均是AECOPD合并T2DM患者住院死亡的独立危险因素;ROC曲线分析显示血清hs-CRP水平的曲线下面积为0.793(95%CI:0.725~0.861,P<0.05),当最佳的诊断截点值为22.69mg/L时,血清hs-CRP水平预测AECOPD合并T2DM死亡的敏感性和特异性分别为80.2%和69.4%。结论血清hs-CRP水平是AECOPD合并T2DM患者住院死亡的独立危险因素,早期检测血清hs-CRP水平对评估AECOPD合并T2DM患者预后有一定的临床意义。Objective To assess the value of hs-CRP for predicting prognosis in AECOPD combined with T2 DM.Methods Three hundred and twenty cases of patients with AECOPD were admitted to the respiratory department of our hospital from January 2014 to December 2017 were selected:the AECOPD combined with T2 DM group(n=152)and AECOPD without T2 DM group(n=168).160 patients with T2 DM and 150 healthy persons as the control group were enrolled into our study.Comparison of these groups on clinical data,FBG,HbA1 c,serum hs-CRP level and so on and application of the receiver operating characteristic curve(ROC curve)analysis of serum hs-CRP level predictive value of the deaths of patients in AECOPD combinedwithT2 DM.Results FBG,HbA1 c and serum hs-CRP level were higher in the AECOPD combined with T2 DM group than the AECOPD without T2 DM group,the T2 DM group and the control group(P<0.05).Patients in AECOPD combined with T2 DM were divided in to two groups:the survival group(n=116)and the death group(n=36).Compared with the survival group,patients in the death group had higher the ratio of Mechanical ventilation,FBG,HbA1 c,serum hs-CRP level and PaCO_(2) while with lower PaO_(2)(P<0.05).Logistic regression analyses showed that Mechanical ventilation,HbA1 c and serum hs-CRP level were risk factors for mortality in patients with AECOPD with T2 DM.According to the analysis of ROC curves,the cut off value of serum hs-CRP level for predicting mortality in patients with AECOPD with T2 DM was set at 22.69 mg/L,with the sensitivity of 80.20%and the specificity of 69.40%.Conclusion Serum hs-CRP level is a risk factor for mortality in patients with AECOPD with T2 DM.Early detection of serum hs-CRP level for assessment of AECOPD with T2 DM prognosis has a certain significance.

关 键 词：HS-CRP AECOPD 2型糖尿病 预后 

分 类 号：R587[医药卫生—内分泌]