降钙素原联合D-二聚体检查评估慢性阻塞性肺病急性加重合并Ⅱ型呼吸功能衰竭患者预后的临床价值分析

Analysis of clinical value of procalcitonin combined with D-dimer test in evaluating prognosis of patients with acute exacerbation of acute chronic obstructive pulmonary disease complicated by typeⅡrespiratory failure

目的本研究旨在评估降钙素原和D-二聚体在慢性阻塞性肺病(COPD)急性加重并发Ⅱ型呼吸功能衰竭患者预后中的作用。通过检测这些生物标志物的水平,了解它们是否可以作为预测患者预后的有效指标。方法研究对象包括94例COPD急性加重并发Ⅱ型呼吸衰竭的患者和50名健康对照者。按现行的指南进行规范的药物治疗,均完成随访,根据28天生存情况,将患者分为预后良好组(65例)和预后不良组(29例),以比较不同组间降钙素原和D-二聚体水平的差异。结果COPD患者组的降钙素原(1.47±0.32)μg/L和D-二聚体(1228.08±120.45)μg/L水平显著高于健康对照组(0.28±0.12)、(270.45±50.10)μg/L,差异有统计学意义。进一步分析发现,预后不良组的降钙素原和D-二聚体水平高于预后良好组。然而,性别、年龄、BMI及其他因素在两组间的差异并不显著。多因素逻辑回归分析表明,降钙素原[OR=1.484,95%CI=(1.093,2.015)]和D-二聚体[OR=2.018,95%CI=(1.110,3.669)]是预后不良的重要独立影响因素。这意味着在控制其他变量后,这两个指标仍然对预后有显著影响。结论本研究表明,血清降钙素原和D-二聚体水平的升高与COPD急性加重合并Ⅱ型呼吸功能衰竭患者的预后不良密切相关。因此,临床医生应重视这两个生物标志物的水平,以便更好地预测患者的病程和结果。

Objective This study aims to evaluate the roles of procalcitonin and D-dimer in the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)complicated by typeⅡrespiratory failure.By measuring the levels of these biomarkers,we aimed to understand if they could serve as effective predictors of patients'prognosis.Methods The study included 94 patients with acute exacerbation of COPD complicated by typeⅡrespiratory failure and 50 healthy controls.Standard drug therapy was administered according to current guidelines,and all patients were followed up.Based on the 28-day survival status,patients were divided into the good prognosis group(65 cases)and poor prognosis group(29 cases)to compare the differences in procalcitonin and D-dimer levels between groups.Results The levels of procalcitonin of the COPD patient group was(1.47±0.32)μg/L and the D-dimer was(1228.08±120.45)μg/L,which were significantly higher than(0.28±0.12)and(270.45±50.10)μg/L in the healthy control group,and the difference was statistically significant.Further analysis revealed that the levels of procalcitonin and D-dimer in the poor prognosis group were higher than those in the good prognosis group.However,differences in gender,age,BMI,and other factors between the two groups were not significant.Multivariate Logistic regression analysis indicated that procalcitonin[OR=1.484;95%CI=(1.093,2.015)]and D-dimer[OR=2.018;95%CI=(1.110,3.669)]were significant independent influencing factors for poor prognosis.This suggested that even after controlling for other variables,these two indicators still had a significant impact on prognosis.Conclusion This study indicates that elevated levels of serum procalcitonin and D-dimer are closely related to poor prognosis in patients with acute exacerbation of COPD complicated by typeⅡrespiratory failure.Therefore,clinicians should pay attention to the levels of these two biomarkers to better predict the course and outcomes of patients.