PTX3与AECOPD患者3年死亡率的相关性研究  

Correlation between PTX3 and 3-year mortality in patients with AECOPD

作　　者：刘佳妤 娄林 闫小京 Liu Jiayu;Lou Lin;Yan Xiaojing(Department of Respiratory and Critical Care Medicine,Tianjin Beichen Hospital,Tianjin 300134,China)

机构地区：[1]天津市北辰医院,天津300134

出　　处：《首都食品与医药》2023年第10期34-38,共5页Capital Food Medicine

摘　　要：目的分析PTX3与AECOPD患者3年死亡率的相关性.方法纳入2017年1月31日-2018年1月31日于天津市北辰医院呼吸与危重症医学科住院的AECOPD患者109例进行回顾性的队列研究,研究的终点事件为全因死亡.所有患者均随访3年,收集患者相关的临床资料,以及入院后的血清PTX3水平和其他基础实验指标,包括C反应蛋白(CRP)、白细胞计数(WBC)、淋巴细胞计数(LC)以及其他常规指标.通过PTX3预测AECOPD患者的全因死亡曲线的最佳截断值10.43进行分组,分为高PTX3组(PTX3≥10.43)和低PTX3组(PTX3<10.43),对比并分析高PTX3组和低PTX3组的一般临床资料,相关实验室指标、并发症以及最后临床结局,将相关的指标与PTX3进行Spearman相关性分析,利用线性回归分析可能影响PTX3的独立影响因素,其中生存曲线的绘制采用Kaplan-Meier法进行绘制,高PTX3与低PTX3组生存率的差异采用Log-Rank法进行分析,并运用COX模型分析AECOPD患者的全因死亡的危险因素.结果所有患者的3年死亡率为39.45%(43例);PTX3预测AECOPD患者死亡的ROC曲线下面积为0.868,灵敏度83.52%,特异度74.16%;高PTX3组与低PTX3组患者在WBC、CRP、LC上均存在统计学差异(P<0.05);在进行Spearman相关性分析后得出PTX3与LC、嗜酸性细胞计数、生存时间呈负相关,PTX3与D-二聚体、WBC以及中性粒细胞呈正相关;在多元线性回归分析中得出PTX3的独立影响因素为CRP、WBC和D-二聚体;Kaplan-Meier法显示低PTX3组的3年生存率高于高PTX3组;COX分析显示PTX3是AECOPD患者全因死亡的独立危险因素.结论PTX3是AECOPD患者全因死亡的独立危险因素,入院早期检测PTX3可以更好地评估患者的预后.Objective To analyze the correlation between PTX3 and 3-year mortality in patients with AECOPD.Methods A retrospective cohort study of 109 AECOPD patients hospitalized in our department from January 31,2017 to January 31,2018 was conducted.The end point of the study was all-cause death.All patients were followed up for 3 years to collect relevant clinical data,serum PTX3 level and other basic experimental indicators after admission,including C-reactive protein(CRP),white blood cell count(WBC),lymphocyte count(LC)and other conventional indicators.The patients were divided into high PTX3 group(PTX3≥10.43)and low PTX3 group(PTX3<10.43).The general clinical data,related laboratory indexes,complications and final clinical outcomes of high PTX3 group and low PTX3 group were compared and analyzed,The survival curve was drawn by Kaplan Meier method,the difference of survival rate between high PTX3 group and low PTX3 group was analyzed by log rank method,and the Cox model was used to analyze the risk factors of all-cause death in AECOPD patients.Results The 3-year mortality of all patients was 39.45%(43 cases);the area under ROC curve of PTX3 was 0.868,the sensitivity was 83.52%,and the specificity was 74.16%;there were significant differences in WBC,CRP and LC between high PTX3 group and low PTX3 group(P<0.05);Spearman correlation analysis showed that PTX3 was negatively correlated with LC,eosinophil count and survival time,while PTX3 was positively correlated with D-dimer,WBC and neutrophils;the independent influencing factors of PTX3 were CRP,WBC and D-dimer;Kaplan Meier method showed that the 3-year survival rate of low PTX3 group was higher than that of high PTX3 group;cox analysis showed that PTX3 was an independent risk factor for all-cause death in AECOPD patients.Conclusion PTX3 is an independent risk factor for all-cause death in AECOPD patients.Early detection of PTX3 on admission can better evaluate the prognosis of patients.

关 键 词：慢性阻塞性肺疾病 白细胞:C反应蛋白 正五聚蛋白3 

分 类 号：R563[医药卫生—呼吸系统]