联合ADL、FEV_(1)%pred、HCT对慢阻肺急性加重患者并发Ⅱ型呼吸衰竭的预测价值研究

Predictive value of combined ADL,FEV_(1)%pred and HCT in patients with acute exacerbation of chronic obstructive pulmonary disease complicated with type 2 respiratory failure

目的研究联合ADL、HCT、FEV_(1)%pred对慢阻肺急性加重患者并发Ⅱ型呼吸衰竭的预测价值。方法选取2019年1月至2022年10月合肥市第二人民医院收治的慢阻肺急性加重患者共306例,根据有无并发Ⅱ型呼衰将其分为呼衰组(97例)与非呼衰组(209例)。经Logistic回归分析探讨慢阻肺急性加重患者并发Ⅱ型呼衰的危险因素,采用受试者工作特征(ROC)曲线评估相关指标的预测价值。结果呼衰组ADL、FEV_(1)/FVC、FEV_(1)%pred及L、PLT低于非呼衰组,HCT高于非呼衰组(P<0.05)。ADL、FEV_(1)%pred、HCT是慢阻肺急性加重患者并发Ⅱ型呼衰的独立危险因素(P<0.05),且三者对其均具有预测价值,AUC分别是0.720、0.778、0.662,联合指标ADL+FEV_(1)%pred+HCT也具有预测价值,AUC为0.833,且联合指标AUC高于个单个指标(P<0.05)。结论ADL、FEV_(1)%pred、HCT是慢阻肺急性加重患者并发Ⅱ型呼衰的独立危险因素,三者联合预测价值优于单个指标。

Objective To investigate the predictive value of combined ADL,FEV_(1)%pred and HCT in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with type 2 respiratory failure.Methods A total of 306 patients with AECOPD hospitalized in the Second People′s Hospital of Hefei from January 2019 to October 2022 were selected,and they were divided into the respiratory failure group(97 cases)and the non-respiratory failure group(209 cases).Logistic regression analysis was used to explore the risk factors for type 2 respiratory failure in patients with AECOPD,and receiver operating characteristic(ROC)curve was used to evaluate the predictive value of related indicators.Results The ADL,FEV_(1)/FVC,FEV_(1)%pred,L and PLT in the HF group were lower than those in the non-HF group,HCT were higher than those in the non-HF group(P<0.05).ADL,FEV_(1)%pred and HCT were independent risk factors of type 2 respiratory failure in patients with AECOPD(P<0.05),and they all had predictive value,with AUC values of 0.720,0.778 and 0.662,respectively.The combined index ADL+FEV_(1)%pred+HCT also had predictive value.The AUC was 0.833.Combined index′s AUC was higher than that of any single index(P<0.05).Conclusion ADL,FEV_(1)%pred and HCT are the independent risk factors of type 2 respiratory failure in patients with AECOPD,and the predictive value of combined indicator is better than that of single indicators.