NLR、FAR及其联合应用对老年慢性阻塞性肺疾病急性加重期患者合并肺动脉高压的预测价值  

Predictive Value of NLR, FAR and Their Combined Application forElderly Patients with Acute Exacerbation of Chronic ObstructivePulmonary Disease Complicated with Pulmonary Hypertension

作　　者：杨晓雪 庞敏[2] Yang Xiaoxue;Pang Min(The first clinical medical college,Shanxi Medical University,Taiyuan 030001;Department of respiratory and critical care medicine,the First Hospital of Shanxi Medical University,Taiyuan 030001)

机构地区：[1]山西医科大学第一临床医学院,太原030001 [2]山西医科大学第一医院呼吸与危重症医学科,太原030001

出　　处：《国际老年医学杂志》2024年第4期432-438,共7页International Journal of Geriatrics

基　　金：山西省卫生健康委新冠科研项目(2023XG025)。

摘　　要：目的 探讨中性粒细胞与淋巴细胞的比值(NLR)、纤维蛋白原与白蛋白的比值(FAR)对老年慢性阻塞性肺疾病急性加重期(AECOPD)患者合并肺动脉高压的预测价值。方法 选取2021年1—6月在山西医科大学第一医院住院的合并肺动脉高压的老年AECOPD患者50例作为合并组,同期未合并肺动脉高压的老年AECOPD患者61例作为对照组。收集患者入院时的临床资料和实验室指标,采用多因素logistic回归分析老年AECOPD患者合并肺动脉高压的危险因素,采用ROC曲线评价NLR、FAR对老年AECOPD患者发生肺动脉高压的预测价值。结果 两组年龄、体质量指数、住院时间、AECOPD严重程度分级、是否使用呼吸机、是否静脉给予激素治疗、抗生素疗程、NLR、FAR、白细胞计数、中性粒细胞计数、血红蛋白、纤维蛋白原、D-二聚体、降钙素原、B型利钠肽、二氧化碳分压、右心房直径、右心室直径、淋巴细胞计数、嗜酸性粒细胞计数、白蛋白、氧合指数、左心房直径及左室舒张末期内径比较,差异均有统计学意义(P<0.05)。多因素logistic回归分析显示,NLR、FAR是老年AECOPD患者发生肺动脉高压的独立危险因素(P<0.05)。ROC曲线显示,NLR联合FAR对肺动脉高压的预测价值最高。结论 NLR、FAR对老年AECOPD患者发生肺动脉高压具有一定的预测价值,两者联合应用时效果更好。Objective To explore the predictive value of Neutrophil-to-lymphocyte ratio(NLR)and fibrinogen-to-albumin ratio(FAR)for elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with pulmonary hypertension.Methods A total of 50 elderly AECOPD patients with pulmonary hypertension who were hospitalized in the First Hospital of Shanxi Medical University from January to June 2021 were selected as the combined group,and 61 elderly AECOPD patients without pulmonary hypertension during the same period were selected as the control group.The clinical data and laboratory parameters of the patients at admission were collected,the risk factors of pulmonary hypertension in elderly patients with AECOPD were analyzed by multivariate logistic regression,and the predictive value of NLR and FAR for pulmonary hypertension in elderly patients with AECOPD was evaluated by ROC curve.Results There were significant differences in age,body mass index,length of hospital stay,AECOPD severity grade,use of ventilator,intravenous hormone therapy,antibiotic course,NLR,FAR,white blood cell count,neutrophil count,hemoglobin,fibrinogen,D-dimer,procalcitonin,B-type natriuretic peptide,partial pressure of carbon dioxide,right atrial diameter,right ventricular diameter,lymphocyte count,eosinophil count,albumin,oxygenation index,left atrial diameter and left ventricular end-diastolic diameter between the two groups(P<0.05).Multivariate logistic regression analysis showed that NLR and FAR were independent risk factors for pulmonary hypertension in elderly patients with AECOPD(P<0.05).ROC curves showed that NLR combined with FAR had the highest predictive value for pulmonary hypertension.Conclusion NLR and FAR have a certain predictive value for elderly AECOPD patients with pulmonary hypertension,and their combined use has a better predictive effect.

关 键 词：慢性阻塞性肺疾病急性加重期 肺动脉高压 中性粒细胞与淋巴细胞的比值 纤维蛋白原与白蛋白的比值 

分 类 号：R563.9[医药卫生—呼吸系统] R544.1[医药卫生—内科学]