血尿酸/肌酐比值和N-末端脑钠肽前体水平在慢性阻塞性肺疾病急性加重期患者预后判断中的应用价值  

Application value of serum uric acid/creatinine ratio and N-terminal pro-brain natriuretic peptide level in prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease

作　　者：王丽兵[1] 张晓东 张贵荣[1] 丁一红 WANG Libing;ZHANG Xiaodong;ZHANG Guirong;DING Yihong(Department of Pneumology,Tianchang Hospital of Traditional Chinese Medicine,Anhui Province,Tianchang 239300,China;Department of Emergency,Fuyang People’s Hospital,Anhui Province,Fuyang 236000,China)

机构地区：[1]安徽省天长市中医院呼吸科,安徽天长239300 [2]安徽省阜阳市人民医院急诊科,安徽阜阳236000

出　　处：《中国医药导报》2022年第23期117-120,共4页China Medical Herald

基　　金：安徽省医学会急诊临床研究项目(Ky2018014)。

摘　　要：目的探究血尿酸(UA)/肌酐(Cr)比值和N-末端脑钠肽前体(NT-proBNP)水平在慢性阻塞性肺疾病急性加重期(AECOPD)患者预后判断中的应用价值。方法选取2018年10月至2020年10月安徽省天长市中医院收治的82例AECOPD患者为研究对象,均完成12个月的随访。根据预后情况将其分为死亡组(10例)和存活组(72例),比较两组血UA/Cr、NT-proBNP水平,分析AECOPD患者预后的影响因素,以及血UA/Cr、NT-proBNP水平评价AECOPD预后的价值。结果本研究中AECOPD患者死亡率为12.20%。死亡组急性生理和慢性健康状况Ⅱ(APACHEⅡ)评分、NT-proBNP、血UA/Cr水平及病情为Ⅳ级占比均高于存活组(P<0.05)。多因素分析显示,APACHEⅡ评分、NT-proBNP、血UA/Cr、病情为Ⅳ级均是AECOPD患者死亡的影响因素(P<0.05)。血UA/Cr和NT-proBNP水平联合预测AECOPD患者死亡的受试者操作特征曲线下面积大于二者单独预测(P<0.05)。结论血UA/Cr和NT-proBNP与AECOPD患者预后关系密切,两者单独及联合检测对患者的预后均有较高的预测效能,且血UA/Cr联合NT-proBNP的预测效能更高。Objective To explore the application value of serum uric acid(UA)/creatinine(CR)ratio and N-terminal pro-brain natriuretic peptide(NT-proBNP)levels in predicting the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 82 patients with AECOPD admitted to Tianchang Hospital of Traditional Chinese Medicine,Anhui Province from October 2018 to October 2020 were selected as the study object,all patients were followed up for 12 months.According to the prognosis,they were divided into death group(10 cases)and survival group(72 cases).Serum UA/Cr and NT-proBNP levels of the two groups were compared to analyze the factors influencing the prognosis of AECOPD patients,and the value of serum UA/Cr and NT-proBNP levels in evaluating the prognosis of AECOPD.Results The mortality rate of AECOPD patients in this study was 12.20%.The levels of acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,NT-proBNP,serum UA/Cr,and the proportion of GradeⅣin death group were higher than those in survival group(P<0.05).Multivariate analysis showed that APACHEⅡscore,NT-proBNP,serum UA/Cr,and GradeⅣwere the influencing factors of death in AECOPD patients(P<0.05).Serum UA/Cr and NT-proBNP levels combined to predict the death of AECOPD patients had a higher area under the receiver operating characteristic curve than those predicted separately(P<0.05).Conclusion Serum UA/Cr and NT-proBNP are closely related to the severity and prognosis of AECOPD patients.Both alone and combined tests have high prognostic efficacy,and serum UA/Cr combined with NT-proBNP have higher prognostic efficacy.

关 键 词：慢性阻塞性肺疾病 急性加重期 血尿酸/肌酐比值 

分 类 号：R563.9[医药卫生—呼吸系统]