BUA、FIB联合RDW预测慢性阻塞性肺疾病急性发作风险的效能

Efficacy of BUA and FIB Combined with RDW in Predicting the Risk of Acute Attack of Chronic Obstructive Pulmonary Disease

目的探讨血尿酸(BUA)、纤维蛋白原(FIB)联合红细胞分布宽度(RDW)预测慢性阻塞性肺疾病(慢阻肺)急性发作风险的效能。方法选取2022年1月—2023年1月收治的159例稳定期慢阻肺进行前瞻性研究,患者入组后随访半年,根据是否发生急性发作分为发作组48例、未发作组111例。比较2组BUA、FIB、RDW,建立慢阻肺急性发作风险的Logistic回归方程,使用Stata 10.0软件确定约登指数最大时,BUA、FIB联合RDW的最佳临界值和预测准确度,受试者工作特征(ROC)曲线分析BUA、FIB、RDW及联合方程预测慢阻肺急性发作的价值,曲线下面积(AUC)评价预测能力。结果发作组BUA、FIB、RDW高于未发作组(P<0.01)。BUA、FIB、RDW升高均是慢阻肺急性加重的独立风险因素(P<0.05,P<0.01)。BUA、FIB联合RDW的最佳临界值为0.101,此时预测准确度为98.25%。ROC曲线分析显示,联合方程预测慢阻肺急性发作的AUC为0.939大于BUA(0.795)、FIB(0.798)、RDW(0.701)单独预测(P<0.05)。对Logistic整体回归方程显著性进行检验显示,F=44.305,R 2=0.820,提示所建立的回归方程有统计学意义,拟合度良好。结论BUA、FIB、RDW升高是稳定期慢阻肺急性发作的相关风险因素,三者联合检测或可作为预测急性发作的可靠方案,能为临床精准分层管理稳定期慢阻肺提供客观依据。

Objective To investigate the efficacy of serum uric acid(BUA),fibrinogen(FIB)and red blood cell distribution width(RDW)in predicting the risk of acute attack of chronic obstructive pulmonary disease(COPD).Methods A prospective study was conducted on 159 patients with stable COPD treated from January 2022 to January 2023.The patients were followed up for six months after enrollment and divided into the attack group(n=48)and the non-attack group(n=111)according to occurrence of acute attack.The Logistic regression equation of acute attack risk of COPD was established by comparing BUA,FIB and RDW in the two groups.Stata 10.0 software was used to determine the optimal critical value and prediction accuracy of combined detection of BUA,FIB and RDW in terms of the maximum Yoden index.Receiver operating characteristic(ROC)curve was used to analyze the value of BUA,FIB,RDW and combined equations in predicting acute attack of COPD,and the area under the ROC curve(AUC)was used to evaluate the predictive ability.Results BUA,FIB and RDW in attack group were higher than those in non-attack group(P<0.01).The increase in BUA,FIB and RDW were independent risk factors for COPD exacerbation(P<0.05,P<0.01).The optimal critical value of BUA and FIB combined with RDW was 0.101,and the prediction accuracy was 98.25%.ROC curve analysis showed that the AUC of combined equation in prediction was 0.939,which was greater than that predicted by BUA(0.795),FIB(0.798)and RDW(0.701)alone(P<0.05).The significance test of the Logistic global regression equation showed that F=44.305 and R 2=0.820,suggesting that the established regression equation had statistical significance and a good fit.Conclusion Elevated BUA,FIB and RDW are risk factors associated with acute attack of stable COPD,and the combined detection of the three may be a reliable scheme for predicting acute attack,providing an objective basis for accurate stratified clinical management of stable COPD.