循环血PCT、NLR、AGR水平及FEV1%pred与慢阻肺患者急性加重期的关联研究  

Association of circulating PCT,NLR,AGR levels and FEV1% pred with risk of readmission for acute exacerbation in COPD patients

作　　者：岳杰 顾玉旗 Yue Jie;Gu Yuqi(Huaxian People's Hospital,Henan Province,Anyang 456400,Henan Province)

机构地区：[1]河南省滑县人民医院,河南安阳456400

出　　处：《辽宁医学杂志》2024年第5期39-42,共4页Medical Journal of Liaoning

摘　　要：目的 研究血清降钙素原(Procalcitonin, PCT)、中性粒细胞/淋巴细胞(NLR)、血清白蛋白/球蛋白(AGR)以及第一秒用力呼气容积占预计值百分比(FEV1%pred)与慢性阻塞性肺病(chronic obstructive pulmonary disease, COPD)患者急性加重的关联。方法 选取我院2020年3月—2022年3月期间收录的COPD患者180例,根据其病情不同分为病情稳定组(n=77)和急性加重组(n=103),同时选取一批体检健康者作为对照组(n=64),对比三组患者的血清PCT、NLR、AGR及FEV1%pred情况,并分析各指标与急性加重再入院风险之间的关系。结果 三组间急性加重组患者的PCT、NLR、AGR>稳定组>对照组;急性加重组患者的FEV1%pred<稳定组<对照组,三组对比差异具有统计学意义(P<0.05),且三组两两对比差异具有统计学意义(P<0.05)。血清PCT、NLR、AGR均与COPD急性加重呈现显著正相关关系(r_(P)=0.608,r_(n)=0.691,r_(A)=0.522,P<0.001);FEV1%pred与COPD急性加重呈现显著负相关关系(r_(F)=-0.726,P<0.001)。血清PCT、NLR、AGR及FEV1%pred检测COPD急性加重的灵敏度分别为62.1%,73.8%,85.4%,90.3%;特异度分别为89.6%,88.3%,74.0%,81.8%;AUC分别为0.818,0.849,0.795,0.858,其中FEV1%pred的灵敏度和AUC最高(P<0.001),PCT的特异度最高(P<0.001)。结论 PCT、NLR、AGR及FEV1%pred均为COPD急性加重的独立危险因素,对各指标进行检测可帮助诊断COPD患者的急性加重期。Objective To investigate the association between serum procalcitonin(PCT),neutrophil/lymphocyte ratio(NLR),serum albumin/globulin ratio(AGR),and forced expiratory volume in the first second in the predicted value(FEV1%pred)and the risk of readmission for acute exacerbation in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 180 patients with COPD admited to our hospital from March 2020 to March 2022 were se-lected and divided into a stable group(n=77)and an acute exacerbation group(n=103)according to their conditions,and a number of healthy subjects were selected as the control group(n=64).Serum PCT,NLR,AGR and FEV1%pred were compared among the three groups,and the relationship between each index and the risk of readmission for acute exacerbation was analyzed.Results The PCT,NLR and ACR of acute plus recombinant patients were>stable group>control group;The FEV1%pred of acute plus recombinant patients was<stable group<control group,the difference among the three groups was statistically significant(P<0.05),and the pairwise difference among the three groups was statistically significant(P<0.05).Serum PCT,NLR and AGR were positively correlated with acute exacerbation of COPD(rp=0.608,r,=0.691,rA=0.522,P<0.001).There was a significant negative correlation between FEV1%pred and COPD exacerbation(r=-0.726,P<0.001).The sensitivity of serum PCT,NLR,AGR and FEV1% pred to detect acute exacerbation of COPD were 62.1%,73.8%,85.4% and 90.3%,respectively.The specificity was 89.6%,88.3%,74.0%,81.8%,respectively.The AUC values were 0.818,0.849,0.795,0.858,respectively.The sensitivity and AUC of FEV1%pred were the highest(P<0.001),and the specificity of PCT was the highest(P<0.001).Conclusion PCT,NLR,AGR and FEV1%pred are all independent risk factors of acute exacerbation of COPD.Detection of PCT,NLR,ACR and FEV1%pred can help to diagnose acute exacerbation of COPD.

关 键 词：降钙素原 中性粒细胞/淋巴细胞 白蛋白/球蛋白 慢性阻塞性肺病 急性加重 

分 类 号：R563.9[医药卫生—呼吸系统]