血清高迁移率族蛋白B1、超敏C反应蛋白/白蛋白、急性生理学与慢性健康状况评分系统Ⅱ评分对慢性阻塞性肺疾病急性加重期患者疾病转归的预测价值分析

Analysis of the predictive value of serum high-mobility family of protein B1,high sensitivity C-reactive protein/albumin and acute physiology and chronic health evaluation Ⅱ score for disease outcome in acute exacerbation phase of chronic obstructive pulmonary disease patients

目的探究血清高迁移率族蛋白B1(HMGB1)、超敏C反应蛋白(hs-CRP)/白蛋白(Alb)及急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分对慢性阻塞性肺疾病急性加重期(AECOPD)患者疾病转归的预测价值。方法选取2021年5月至2023年4月赣南医科大学第一附属医院南康院区收治的116例AECOPD患者作为研究对象,根据病情转归不同分为好转组(n=84)和恶化组(n=32)。检测血清HMGB1、hs-CRP/Alb水平,并评估APACHEⅡ评分。多因素logistic回归分析影响AECOPD患者疾病转归的因素。采用受试者工作特性(ROC)曲线分析血清HMGB1、hs-CRP/Alb水平及APACHEⅡ评分对AECOPD患者疾病转归的预测价值。结果恶化组血清HMGB1、hs-CRP/Alb,APACHEⅡ评分高于好转组,差异有统计学意义(P<0.05)。多因素分析结果提示高HMGB1(β=0.093,OR=1.097,95%CI:1.035~1.164)、高hs-CRP/Alb(β=0.208,OR=1.231,95%CI:1.057~1.435)、高APACHEⅡ评分(β=0.049,OR=1.050,95%CI:1.004~1.099)、病程长(β=0.109,OR=1.115,95%CI:1.058~1.176)是AECOPD发生病情恶化的危险因素(P<0.05)。血清HMGB1、hs-CRP/Alb、APACHEⅡ评分预测AECOPD患者疾病转归的曲线下面积(AUC)分别为0.756、0.735、0.772,联合检测为0.817。结论AECOPD患者血清HMGB1、hs-CRP/Alb升高,APACHEⅡ评分升高,三者与患者疾病转归密切相关,联合血清HMGB1、hs-CRP/Alb、APACHEⅡ评分在预测AECOPD患者疾病转归中具有较好的效能。

Objective To explore the predictive value of serum high mobility group protein B1(HMGB1),hypersensitive C-reactive protein(hs-CRP)/albumin(Alb)and acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score for disease outcome in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 116 AECOPD patients admitted to Nankang Campus of the First Affiliated Hospital of Gannan Medical University from May 2021 to April 2023 were selected and divided into improved group(n=84)and worsened group(n=32)according to different disease outcomes.Serum HMGB 1,hs-CRP/Alb levels were measured and the APACHEⅡ score was assessed.Multivariate logistic regression analysis of factors affecting disease outcome in AECOPD patients.The predictive value of serum HMGB 1,hs-CRP/Alb levels and APACHEⅡ score for disease conversion in AECOPD patients was analyzed using receiver operating characteristic(ROC)curve.Results Serum HMGB 1,hs-CRP/Alb and APACHEⅡ score in worsened group were higher than the improved group,with statistical significances(P<0.05).Multivariate analysis results prompted that high HMGB1(β=0.093,OR=1.097,95%CI:1.035-1.164),high hs-CRP/Alb(β=0.208,OR=1.231,95%CI:1.057-1.435),high APACHEⅡ score(β=0.049,OR=1.050,95%CI:1.004-1.099),and long disease course(β=0.109,OR=1.115,95%CI:1.058-1.176)were risk factors for AECOPD deterioration(P<0.05).The area under the curve(AUC)of serum HMGB 1,hs-CRP/Alb,and APACHEⅡ score to predict the disease outcome in AECOPD patients was 0.756,0.735 and 0.772,respectively,and the combined test was 0.817.Conclusion The serum HMGB1,hs-CRP/Alb and APACHEⅡ score of AECOPD patients increase,which are closely relate to the disease conversion of patients,the combination of serum HMGB1,hs-CRP/Alb and APACHEⅡscore had good efficacy in predicting the disease conversion of AECOPD patients.