血清sCD163、CRP联合纤维蛋白原检测对AECOPD预后的预测价值  

Predictive value of serum sCD163 and CRP combined with fibrinogen detection on prognosis of AECOPD

作　　者：张静[1,2] 周沈之 李燕 李殿明 ZHANG Jing;ZHOU Shenzhi;LI Yan;LI Dianming(Bengbu Medical College,Bengbu Anhui 233000,China)

机构地区：[1]蚌埠医学院,安徽蚌埠233000 [2]凤阳县人民医院呼吸与危重症医学科,安徽凤阳233100 [3]蚌埠医学院第一附属医院呼吸与危重症医学科,安徽蚌埠233004

出　　处：《中国急救复苏与灾害医学杂志》2022年第10期1327-1330,1335,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：安徽省教育厅自然科学研究重点项目(编号:KJ2018A0997)。

摘　　要：目的 探讨血清可溶性血红蛋白道夫受体163(sCD163)、C反应蛋白(CRP)联合纤维蛋白原(FIB)检测对慢性阻塞性肺疾病急性加重期(AECOPD)预后的预测价值。方法 选取2021年1月—2021年12月期间凤阳县人民医院收治的98例AECOPD患者为观察对象。根据住院治疗后AECOPD患者的预后,分为恶化组和好转组,比较两组患者的临床资料。采用Logistic多因素回归分析影响AECOPD患者预后的危险因素。制作受试者工作特征(ROC)曲线,以曲线下面积(AUC)分析血清sCD163、CRP联合FIB对AECOPD患者预后的预测价值。结果本研究中AECOPD患者病情恶化发生率为23.47%。恶化组急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、白细胞计数(WBC)、sCD163、CRP及FIB水平均高于好转组(均P<0.05)。Logistic回归分析结果显示,APACHEⅡ评分、血清sCD163、CRP及FIB均为影响AECOPD患者预后的危险因素(OR=2.724、3.340、2.757、2.818,P<0.05)。ROC分析显示,血清sCD163、CRP及FIB预测AECOPD患者预后的最佳截断点分别为120.35 pg/mL、68.42 mg/L、4.03 g/L,血清sCD163、CRP及FIB三者联合对AECOPD患者预后预测的AUC为0.918,高于血清sCD163、CRP、FIB单独预测的AUC(P<0.05)。结论 血清sCD163、CRP联合FIB检测对AECOPD患者预后预测的效能较高,可作为临床评估AECOPD患者预后的重要参考指标。ObjectiveTo explore the prognostic value of serum soluble hemoglobin doffer receptor 163(sCD163),Creactive protein(CRP)and fibrinogen(FIB)in the prognosis of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).MethodsA total of 98 AECOPD patients admitted to the First Affiliated Hospital of Fengyang County People Hospital from January 2021 to December 2021 were selected as observation objects.Relevant clinical data were collected.Peripheral fasting venous blood samples were collected the day after to detect the serum sCD163 by ELISA,CRP by turbidimity,and fibrinogen by freezing method.Logistic multivariate regression analysis was used to identify the risk factors affecting the prognosis of AECOPD patients.Receiver operating characteristic curve(ROC)was made,and the area under the curve(AUC)was used to analyze the predictive values of serum sCD163,CRP combined with FIB on the prognosis of AECOPD patients.ResultsThrough observation,the condition of 23 patients was worsened with a worsening rate of 23.47%.The APACHEⅡscore,white blood cell count,sCD163,CRP and FIB levels in the deterioration group were all significantly higher than those of the improvement group(all P<0.05).Logistic regression analysis showed that APACHEⅡscore,serum sCD163,CRP and FIB were risk factors affecting the prognosis of AECOPD patients(OR=2.724,3.340,2.757,2.818,P<0.05).ROC analysis showed that the best cut-off points of serum sCD163,CRP and FIB for predicting the prognosis of AECOPD patients were 120.35 pg/mL,68.42 mg/L,4.03 g/L,respectively.The AUC for predicting the prognosis of the AECOPD patients was 0.918,significantly higher than the AUC values predicted by serum sCD163,CRP and FIB alone(Z=2.897,P=0.004;Z=2.757,P=0.006;Z=2.906,P=0.004).ConclusionThe combination of serum sCD163,CRP,and FIB has a high efficacy in predicting the prognosis of AECOPD patients,and can be used as an important reference index for clinical evaluation of the prognosis of AECOPD patients.

关 键 词：可溶性血红蛋白道夫受体163 C反应蛋白 纤维蛋白原 慢性阻塞性肺疾病急性加重期 预后 

分 类 号：R563[医药卫生—呼吸系统]