血清胰岛素样生长因子-1、脑钠肽前体及血小板/淋巴细胞比值对慢性阻塞性肺疾病急性加重期三联吸入疗法治疗反应性的预测价值  

Predictive value of serum insulin-like growth factor,pro-brain natriuretic peptide precursor,and platelet-lymphocyte ratio for the therapeutic response to triple inhalation therapy in patients with acute exacerbations of chronic obstructive pulmonary disease

作　　者：张翠云 王燕 徐立婷 Zhang Cuiyun;Wang Yan;Xu Liting(Department of Respiratory and Critical Care Medicine,Xingtai General Hospital,North China Medical and Health Group,Xingtai Hebei 054000,China)

机构地区：[1]华北医疗健康集团邢台总医院呼吸与危重症医学科,河北邢台054000

出　　处：《中国医刊》2025年第4期395-400,共6页Chinese Journal of Medicine

基　　金：河北省重点研发计划(22109312819D)。

摘　　要：目的探讨血清胰岛素样生长因子-1(IGF-1)、脑钠肽前体(pro-BNP)、血小板/淋巴细胞比值(PLR)对慢性阻塞性肺疾病急性加重期(AECOPD)三联吸入疗法治疗反应性的预测价值。方法选取2022年2月至2023年6月华北医疗健康集团邢台总医院收治的132例接受三联吸入疗法治疗的AECOPD患者,治疗7 d后根据慢性阻塞性肺疾病(COPD)评估测试(COPD assessment test,CAT)评分评估治疗反应性,根据评估结果分为反应性良好组(47例,CAT评分较入院时改善≥2分)和反应性不良组(85例,CAT评分较入院时改善<2分)。比较两组患者的临床指标、IGF-1水平、pro-BNP水平及PLR,分析IGF-1、pro-BNP、PLR与临床指标的相关性及对AECOPD患者治疗反应性的预测价值,并分析不同水平IGF-1、pro-BNP、PLR对AECOPD治疗反应性不良的预测价值。结果反应性不良组的中性粒细胞计数、C反应蛋白、D-二聚体、pro-BNP水平、凝血酶原时间、PLR均高于反应性良好组,淋巴细胞计数、白蛋白、IGF-1水平低于反应性良好组,差异均有统计学意义(P<0.05);IGF-1与中性粒细胞计数、C反应蛋白、D-二聚体、凝血酶原时间呈负相关,与淋巴细胞计数、白蛋白呈正相关(P<0.05),pro-BNP、PLR与中性粒细胞计数、C反应蛋白、D-二聚体、凝血酶原时间呈正相关,与淋巴细胞计数、白蛋白呈负相关(P<0.05)。校正其他因素后,logistic回归分析显示,IGF-1、pro-BNP、PLR均为AECOPD患者三联吸入疗法治疗反应性不良的独立影响因素(P<0.05)。ROC曲线分析显示,IGF-1、pro-BNP、PLR联合预测AECOPD三联吸入疗法治疗反应性的曲线下面积最大,为0.935(95%CI 0.879~0.971)。结论血清IGF-1、pro-BNP及PLR与AECOPD三联吸入疗法的治疗反应性密切相关,也是AECOPD三联吸入疗法治疗反应性不良的独立影响因素,三者联合有助于提高对AECOPD三联吸入疗法治疗反应性的预测价值。Objective To explore the predictive value of serum insulin-like growth factor(IGF-1),brain natriuretic peptide precursor(pro-BNP),and platelet-lymphocyte ratio(PLR)on the therapeutic response of triple inhalation therapy for acute exacerbations of chronic obstructive pulmonary disease(AECOPD).Method A total of 132 patients with AECOPD who received triple inhalation therapy at Xingtai General Hospital from February 2022 to June 2023 were selected.After 7 days of treatment,After 7 days of treatment,the treatment response was assessed using the COPD Assessment Test(COPD assessment test,CAT)score.Based on the assessment results,132 patients were divided into the good response group(47 cases,CAT score improved by≥2 points compared to admission)and the poor response group(85 cases,CAT score improved by<2 points compared to admission).The clinical indicators,IGF-1 levels,pro-BNP levels and PLR were compared between the two groups of patients,the correlation between the three and clinical indicators and their predictive value for the treatment response of AECOPD patients were analyzed.Result The levels of neutrophil count,C-reactive protein,D-dimer,pro-BNP,prothrombin time,and PLR in the poor response group were higher than those in the good response group,while the lymphocyte count,albumin,and IGF-1 levels were lower than those in the good response group,with statistically significant differences(P<0.05).IGF-1 was negatively correlated with neutrophil count,C-reactive protein,D-dimer,and prothrombin time(P<0.05).IGF-1 was positively correlated with lymphocyte count and albumin(P<0.05).Pro-BNP and PLR were positively correlated with neutrophil count,C-reactive protein,D-dimer,and prothrombin time,and negatively correlated with lymphocyte count and albumin(P<0.05).Logistic regression analysis after correcting for other factors showed that IGF-1,pro-BNP,and PLR were all independent influences on poor treatment responsiveness to triple inhalation therapy in patients with AECOPD(P<0.05).The ROC curve results showed that th

关 键 词：胰岛素样生长因子-1 脑钠肽前体 血小板/淋巴细胞比值 慢性阻塞性肺疾病急性加重期 雾化吸入 治疗反应性 

分 类 号：R563[医药卫生—呼吸系统]