hs-CRP与白蛋白比值对呼吸衰竭COPD患者撤机失败的预测价值  

Predictive value of hs-CRP to albumin ratio for weaning failure in COPD patients with respiratory failure

作　　者：徐晓敏 余鸿艳 徐茂华 韩利峰 XU Xiaomin;YU Hongyan;XU Maohua;HAN Lifeng(Department of Emergency Medicine,Chun'an Branch of Zhejiang Provincial People's Hospital,Hangzhou,Zhejiang 311700,China;不详)

机构地区：[1]浙江省人民医院淳安分院急诊医学科,浙江杭州311700 [2]浙江省人民医院淳安分院呼吸内科

出　　处：《中华全科医学》2025年第2期190-193,共4页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2023XY015)。

摘　　要：目的 通过探讨超敏C反应蛋白(hs-CRP)与白蛋白(Alb)与呼吸衰竭慢性阻塞性肺疾病(COPD)患者撤机失败的关系,分析其对该类患者撤机失败的预测价值。方法 选取2022年10月—2023年10月浙江省人民医院淳安分院收治的242例呼吸衰竭COPD患者,根据撤机结果将患者分为2组:撤机成功组(180例)与撤机失败组(62例)。采用单因素分析比较2组患者的一般资料,采用多因素logistic回归分析法分析呼吸衰竭COPD患者撤机失败的影响因素,绘制ROC曲线分析hs-CRP与Alb比值对呼吸衰竭COPD患者撤机失败的预测价值。结果 撤机成功组患者年龄、急性生理与慢性健康评分(APACHEⅡ)、hs-CRP、hs-CRP与Alb比值、胃肠功能受损发生率较撤机失败组低,机械通气时间较撤机失败组短,Alb水平较撤机失败组高(P<0.05);logistic回归分析结果显示,年龄较大、APACHEⅡ评分高、hs-CRP与Alb比值较高均为呼吸衰竭COPD患者撤机失败的危险因素;ROC曲线结果显示,年龄、APACHEⅡ、hs-CRP与Alb比值预测呼吸衰竭COPD患者撤机失败的AUC为0.735、0.716、0.927,其中hs-CRP与Alb比值的预测价值最高。结论 呼吸衰竭COPD患者撤机失败的发生与hs-CRP与Alb比值的上升有关,其可以作为撤机失败发生的预测因子。Objective By analyzing the relationship between high-sensitivity C-reactive protein(hs-CRP)and albumin(Alb)and the failure of weaning in patients with respiratory failure and chronic obstructive pulmonary disease(COPD),the predictive value of weaning failure in this disease is analyzed.Methods A retrospective analysis was conducted on 242 patients with respiratory failure COPD at Chun'an Branch of Zhejiang Provincial People's Hospital from October 2022 to October 2023.The cases were were divided into a successful weaning group(180 cases)and a failed weaning group(62 cases)based on the weaning outcome.Univariate analysis was used to analyze the general information of two groups of patients,and multiple logistic regression analysis was used to analyze the influencing factors of weaning failure in COPD patients with respiratory failure.ROC curves were plotted to analyze the predictive value of hsCRP to Alb ratio for weaning failure in COPD patients with respiratory failure.Results The age,acute physiology and chronic health score(APACHEⅡ),hs-CRP,hs-CRP to Alb ratio,incidence of gastrointestinal dysfunction,mechanical ventilation time,and Alb level of patients in the successful weaning group were lower than those in the failed weaning group(P<0.05),the duration of mechanical ventilation was shorter than that of the failed weaning group and the Alb levels were higher than that of the failed weaning group(P<0.05).Older age,high APACHEⅡscore,and high hs-CRP to Alb ratio are all risk factors for failed weaning in COPD patients with respiratory failure.The ROC curve results showed that age,APACHEⅡ,hs-CRP to Alb ratio had AUC values of 0.735,0.716,and 0.927 for the failure of weaning in COPD patients with respiratory failure,among them,the hs-CRP to Alb ratio had the highest predictive value.Conclusion The occurrence of weaning failure in COPD patients with respiratory failure is related to the increase in the ratio of hs-CRP to Alb,which can serve as an early predictor of weaning failure.

关 键 词：慢性阻塞性肺疾病 超敏C反应蛋白 白蛋白 呼吸衰竭 撤机 

分 类 号：R563[医药卫生—呼吸系统] R563.8[医药卫生—内科学]