血清同型半胱氨酸检测联合Wells评分对慢性阻塞性肺疾病急性加重期患者发生静脉血栓栓塞症的预测价值研究  

Study on the predictive value of serum homocysteine detection and Wells score for venous thromboembolism in patients with acute exacerbation of chronic obstructive pulmonary disease

作　　者：谢忠莲 唐铭 龚世维 陈蓉 XIE Zhonglian;TANG Ming;GONG Shiwei;CHEN Rong(Department of Geriatrics,Guanghan People′s Hospital,Guanghan,Sichuan 618300,China)

机构地区：[1]广汉市人民医院老年医学科,四川广汉618300

出　　处：《临床肺科杂志》2024年第3期342-346,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的探究血清同型半胱氨酸(Hcy)检测联合Wells评分对慢性阻塞性肺疾病急性加重期患者发生静脉血栓栓塞症(VTE)的预测价值。方法选取2021年4月-2023年4月我院收治的94例慢性阻塞性肺疾病急性加重期患者,根据是否发生VTE分为VTE组20例和非VTE组74例。采用酶联免疫吸附测定(ELISA)法检测血清中Hcy水平。对全部患者进行Wells评分。Spearman相关性分析Hcy表达水平与Wells评分的关系;ROC曲线分析血清Hcy检测联合Wells评分对慢性阻塞性肺疾病急性加重期患者发生VTE的预测价值;Logistic回归分析影响慢性阻塞性肺疾病急性加重期患者VTE发生的因素。结果与非VTE组相比,VTE组患者C-反应蛋白(CRP)、D-二聚体(D-D)、Hcy水平以及Wells评分水平显著升高,动脉血氧分压(PaO_(2))水平显著降低(P<0.05)。Pearson相关性分析显示,慢性阻塞性肺疾病急性加重期患者Hcy表达水平与Wells评分呈正相关关系(r=0.491,P<0.05)。二者联合预测慢性阻塞性肺疾病急性加重期患者发生VTE的AUC高于血清Hcy表达水平与Wells评分单独预测的AUC值(Z=5.303,P<0.001;Z=9.151,P<0.001)。Logistic回归分析结果显示Hcy、Wells评分为VTE发生的影响因素(P<0.05)。结论慢性阻塞性肺疾病急性加重期发生VTE患者血清Hcy水平和Wells评分显著上升,二者联合检测对慢性阻塞性肺疾病急性加重期发生VTE的预测价值优于单一指标检测。Objective To explore the predictive value of serum homocysteine(Hcy)detection combined with Wells score for venous thromboembolism(VTE)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods From April 2021 to April 2023,94 patients with AECOPD accepted by our hospital were gathered and grouped into a VTE group of 20 cases and a non-VTE group of 74 cases based on whether VTE occurred.Enzyme-linked immunosorbent assay(ELISA)was applied to detect the level of Hcy in serum.Wells scoring was performed on all patients.Spearman correlation was applied to analyze the relationship between Hcy expression level and Wells score;receiver operating characteristic was applied to analyze the predictive value of serum Hcy detection combined with Wells score for VTE in patients with AECOPD;Logistic regression was applied to analyze the factors affecting the occurrence of VTE in patients with AECOPD.Results Compared with the non-VTE group,the levels of C-reactive protein(CRP),D-dimer(D-D),Hcy,and Wells score in the VTE group were higher,and the level of arterial partial oxygen pressure(PaO_(2))was lower(P<0.05).Pearson correlation analysis showed a positive correlation between Hcy expression level and Wells score in patients with AECOPD(r=0.491,P<0.05).The AUC the combination of the two in predicting VTE in patients with AECOPD was higher than that predicted by serum Hcy expression levels and Wells score alone(Z=5.303,P<0.001;Z=9.151,P<0.001).The results of logistic regression analysis showed that Hcy and Wells scores were the influencing factors for the occurrence of VTE(P<0.05).Conclusion The serum Hcy level and Wells score of patients with AECOPD and VTE are increased,and their predictive value for VTE in AECOPD patients is better than single indicator detection.

关 键 词：同型半胱氨酸 WELLS评分 慢性阻塞性肺疾病急性加重期 静脉血栓栓塞症 预测 

分 类 号：R563.9[医药卫生—呼吸系统]