HALP评分及GNRI对老年AECOPD患者的预后价值

Prognostic Value of Hemoglobin-albumin-ly mphocyte-platelet Score and Geriatric Nutritional Risk Index in the Elderly Patients with A-cute Exacerbation of Chronic Obstructive Pulmonary Disease

目的探讨血红蛋白-白蛋白-淋巴细胞-血小板(hemoglobin-albumin-lymphocyte-platelet,HALP)评分及老年营养风险指数(geriatric nutritional risk index,GNRI)对老年慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者预后的价值。方法回顾性分析2018年9月~2022年3月郑州大学第二附属医院呼吸与危重症医学科收治的228例老年AECOPD患者的临床及随访资料。患者出院后均接受1年随访,按预后情况分为两组,即预后良好组(n=130)和预后不良组(n=98),比较两组患者的资料。采用受试者工作特征(receiver operating characteristic,ROC)曲线分析HALP评分及GNRI对老年AECOPD患者预后不良的预测效能。采用相关性分析的方法探讨HALP评分及GNRI与C反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)、降钙素原(procalcitonin,PCT)、营养风险筛查评分(NRS2002)、住院时长及预后结局的相关性。结果预后良好组的体重指数、淋巴细胞计数、血红蛋白、白蛋白、GNRI、HALP评分均高于预后不良组,年龄、住院时长、NRS2002、血小板计数、中性粒细胞计数、CRP、IL-6、PCT、痰培养、胸部CT合并肺炎方面均低于预后不良组,差异有统计学意义(P<0.05);ROC曲线分析结果表明,HALP评分及GNRI的曲线下面积(area under the curve,AUC)分别为0.868和0.682。相关性分析结果显示,老年AECOPD患者HALP评分及GNRI均与CRP、PCT、NRS2002、住院时长、预后结局、痰培养及胸部CT合并炎症呈负相关(P<0.05),且GNRI还与IL-6呈负相关(P<0.05)。结论HALP评分及GNRI能预测老年AECOPD患者的预后结局。

Objective To explore the prognostic value of hemoglobin-albumin-lymphocyte-platelet(HALP)score and geriatric nutritional risk index(GNRI)in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A retrospective analysis was conducted on the clinical and follow-up data of 228 elderly AECOPD patients who were admitted to the De-partment of Respiratory and Critical Care Medicine,the Second Afliated Hospital of Zhengzhou University from September 2018 to March 2022.After discharge,the patients received 1-year follow-up,and were divided into two groups based on their prognosis:good progno-sis group(n=130)and poor prognosis group(n=98),and the data were compared between the two groups.The predictive effect of HALP score and GNRI on poor prognosis in elderly AECOPD patients was analyzed by receiver operating characteristic(ROC)curve.The correlation analysis was used to investigate the relationship between HALP score and GNRI and C-reactive protein(CRP),interleukin-6(IL-6),procalcitonin(PCT),NRS2002,length of hospital stay and prognostic outcomes.Results The levels of body mass index,lymphocyte count,hemoglobin,albumin,GNRI,and HALP score in the good prognosis group were higher than those in the poor prognosis group,and the age,length of hospitalization,NRS2002,neutrophil count,CRP,IL-6,PCT,sputum culture,chest CT combined with inflammation were lower than those in the poor prognosis group,and the differences were statistically significant(P<0.05).The results of ROC curves indicate that the area under the curve(AUC)of HALP score and GNRI were O.868 and 0.682 respectively.The results of correlation analysis showed that in elderly patients with AECOPD,both HALP score and GNRI were negatively correlated with CRP,PCT,NRS2002,length of hospitalization,prognostic outcomes,sputum culture,and chest CT with inflammation(P<0.05),and GNRI was also negatively correlated with IL-6(P<0.05).Conclusion HALP score and CNRI can predict the prognostic outcome of elderly pa-tientswithAECOPD.