PCT、D-D、NLR、Cys-C与慢性阻塞性肺疾病急性加重期患者的相关性及对预后的预测价值

Correlation between PCT,D-D,NLR,Cys-C and AECOPD patients and its prognostic value

目的分析降钙素原(PCT)、D二聚体(D-D)、中性粒细胞与淋巴细胞比值(NLR)、胱抑素C(Cys-C)与慢性阻塞性肺病急性加重期(AECOPD)患者的相关性,并探讨其对患者预后的预测价值。方法选取2019年10月~2021年10月北京市东城区第一人民医院收治的106例慢性阻塞性肺病(COPD)患者,依据疾病的严重程度分为发作组(n=50)和稳定组(n=56)。对所有患者随访1年,将1年内死亡的患者设为预后不良组,将1年内存活的患者设为预后良好组。检测各组研究对象的血清PCT、D-D、NLR、Cys-C水平,以Spearman相关性分析PCT、D-D、NLR、Cys-C水平与COPD患者急性加重期的相关性,以ROC分析PCT、D-D、NLR、Cys-C水平对COPD患者预后的预测价值。结果发作组的血清PCT、D-D、NLR、Cys-C水平高于稳定组,差异有统计学意义(P<0.05);预后不良组的血清PCT、D-D、NLR、Cys-C水平高于预后良好组,差异有统计学意义(P<0.05)。Spearman相关性分析结果显示,血清PCT、D-D、NLR、Cys-C水平与AECOPD均呈正相关(r=0.491、0.475、0.487、0.429,P<0.05)。ROC曲线分析结果显示,血清PCT、D-D、NLR、Cys-C水平联合预测AECOPD患者不良预后的曲线下面积(AUC)为0.982,灵敏度为100.00%,特异性为95.24%。结论血清PCT、D-D、NLR、Cys-C水平与AECOPD的发生密切相关,早期检测血清PCT、D-D、NLR、Cys-C水平对AECOPD患者的预后具有一定的预测价值,且各指标联合预测的效能更佳。

Objective To analyze the correlation between procalcitonin(PCT),D-dimer(D-D),neutrophil to lymphocyte ratio(NLR),cystatin C(Cys-C)and patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and to explore its predictive value for the prognosis of patients with AECOPD.Methods According to the severity of the disease,106 patients with chronic obstructive pulmonary disease(COPD)admitted to our hospital from February 2019 to February 2022 were divided into acute exacerbation stage and stable disease stage,with acute exacerbation stage as attack group(n=50)and stable disease stage as stable group(n=56).All patients were followed up for 1 year.The patients who died within 1 year were set as the poor prognosis group,and the patients who survived within 1 year were set as the good prognosis group.The serum levels of PCT,D-D,NLR and Cys-C of the subjects in each group were measured.The correlation between the levels of PCT,D-D,NLR and Cys-C and the acute exacerbation of COPD patients was analyzed by Spearman correlation.The predictive value of PCT,D-D,NLR and Cys-C levels on the prognosis of COPD patients was analyzed by ROC.Results The levels of serum PCT,D-D,NLR and Cys-C in the attack group were higher than those in the stable group(P<0.05).The serum levels of PCT,D-D,NLR and Cys-C in the poor prognosis group were higher than those in the good prognosis group(P<0.05).Spearman correlation analysis showed that serum PCT,D-D,NLR,Cys-C levels were positively correlated with AECOPD(r=0.491,0.475,0.487,0.429,P<0.05).The ROC curve analysis result showed that the area under the curve(AUC)of the combined prediction of serum PCT,D-D,NLR and Cys-C levels for the adverse prognosis of AECOPD patients was 0.982,the sensitivity was 100.00%,and the specificity was 95.24%.Conclusion Serum PCT,D-D,NLR,Cys-C levels are closely related to the occurrence of AECOPD.Early detection of serum PCT,D-D,NLR,Cys-C levels has certain predictive value for the prognosis of AECOPD patients,and the combined prediction of various indicators is better.