血尿素氮与血清白蛋白比值对慢性阻塞性肺疾病急性加重期患者预后的预测价值

Prognostic value of blood urea nitrogen to serum albumin ratio in patient s with acute exacerbation of chronic obstructive pulmonary disease

目的:探究血尿素氮与血清白蛋白比值对慢性阻塞性肺疾病急性加重期患者预后的预测价值。方法:采取回顾性分析法,选取湛江中心人民医院2021年1月至2022年12月期间收治的60例慢性阻塞性肺疾病急性加重期患者作为研究对象。所有患者均接受血尿素氮与血清白蛋白比值检测,根据检测结果分为观察组和对照组,其中观察组32例,血尿素氮与血清白蛋白比值为(9.03±8.65),对照组28例,血尿素氮与血清白蛋白比值为(24.65±10.65)。对两组的预后进行观察,包括住院时间、心力衰竭症状改善时间、不同分级慢性阻塞性肺疾病患者的营养状态(血清白蛋白、体质指数、微型营养评分)和血气分析指标(血液pH、动脉血二氧化碳分压、动脉血氧分压)以及死亡率。结果:(1)观察组的住院时间和心力衰竭症状改善时间均显著长于对照组(P<0.05)。(2)两组中不同分级慢性阻塞性肺疾病患者病情分级越高则血清白蛋白、体质指数、微型营养评分越差,且组间对比差异有统计学意义(P<0.05)。(3)两组中不同分级慢性阻塞性肺疾病患者的血液pH值、动脉血二氧化碳分压、动脉血氧分压相比,差异有统计学意义(P<0.05)。(4)观察组的死亡率为46.88%(15/32),显著高于对照组的17.86%(5/28),差异有统计学意义(P<0.05)。结论:血尿素氮与血清白蛋白比值对慢性阻塞性肺疾病急性加重期患者的预后有较高的预测价值,该指标越低提示患者的健康状况和血气状态越差,死亡风险越高。

Objective:To investigate the prognostic value of the ratio of blood urea nitrogen to serum albumin in patients with acute exacerbation of chronic obstructive pulmonary disease.Methods:By retrospective analysis,60 patients with acute exacerbation of chronic obstructive pulmonary disease admitted to Zhanjiang Central People’s Hospital from January 2021 to December 2022 were selected as research objects.All patients were tested for the ratio of blood urea nitrogen to serum albumin,and were divided into observation group and control group according to the test results.Among them,32 patients in observation group had the ratio of blood urea nitrogen to serum albumin(9.03±8.65),and 28 patients in control group had the ratio of blood urea nitrogen to serum albumin(24.65±10.65).The outcomes of the two groups were observed,including length of hospital stay,time to improvement of heart failure symptoms,nutritional status(serum albumin,body mass index,microtrophic score)and blood gas analysis indicators(blood pH,arterial partial pressure of carbon dioxide,arterial partial pressure of oxygen)and mortality in patients with different grades of COPD.Results:(1)The hospitalization time and the improvement time of heart failure symptom in observation group were significantly longer than those in control group(P<0.05).(2)The higher the disease grade of patients with different grades of COPD in the two groups,the worse the serum albumin,body mass index and micronutrient score,and the difference between groups was statistically significant(P<0.05).(3)There were statistically significant differences in blood pH value,arterial partial pressure of carbon dioxide and arterial partial pressure of oxygen in patients with different grades of COPD between the two groups(P<0.05).(4)The mortality rate of the observation group was 46.88%(15/32),which was significantly higher than that of the control group 17.86%(5/28),and the difference was statistically significant(P<0.05).Conclusion:The ratio of blood urea nitrogen to serum albumin has a high predictive value for the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease.The lower the ratio,the worse the health status and blood gas status of patients,the higher the risk of death.