摘要
目的分析频繁急性加重的慢性阻塞性肺疾病(COPD)继发肺动脉高压(PAH)的危险因素。方法回顾性分析于郑州大学第一附属医院2018年4月至2020年4月住院的频繁急性加重的122例COPD患者的病历资料,根据多普勒超声心动图(DE)测得的肺动脉压分为PAH组(62例)与非PAH组(60例)。收集两组年龄、性别、吸烟指数、血常规、炎症指标、生化等临床资料进行比较,应用多因素logistic回归分析频繁急性加重的COPD继发PAH的危险因素,采用受试者工作曲线(ROC)分析各指标对频繁急性加重的COPD继发PAH的预测价值。结果两组性别、年龄、病程、吸烟指数比较,差异无统计学意义(P>0.05)。PAH组中性粒细胞计数(NEUT)、中性粒细胞/淋巴细胞比值(NLR)、N端脑钠肽前体(NT-pro BNP)水平高于非PAH组,淋巴细胞计数(LY)、白蛋白水平低于非PAH组,右室径大于非PAH组(P<0.05)。两组白细胞计数(WBC)、血沉(ESR)、C反应蛋白(CRP)、降钙素原(PCT)水平比较,差异无统计学意义(P>0.05)。多因素logistic回归分析显示,NLR>5.61、NT-pro BNP>590.61 ng·L-1是频繁急性加重的COPD继发PAH的独立危险因素(P<0.05)。ROC曲线显示,NLR与NT-pro BNP预测频繁急性加重的COPD继发PAH的曲线下面积分别为0.688、0.789。结论NLR>5.61、NT-pro BNP>590.61 ng·L-1是频繁急性加重的COPD继发PAH的独立危险因素,对其具有较高的预测价值。
Objective To explore the risk factors of pulmonary hypertension(PAH)secondary to frequent acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods The medical records of 122 patients with frequent acute exacerbation of COPD who were hospitalized from April 2018 to April 2020 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed.They were divided into PAH group(62 cases)and non-PAH group(60 cases)based on the pulmonary artery pressure measured by Doppler echocardiography(DE).Age,gender,smoking index,blood routine,inflammation index,biochemistry,etc.of the two groups were collected for comparison.Multivariate logistic regression was applied to analyze the risk factors of PAH secondary to frequent acute exacerbation of COPD,and receiver operating curve(ROC)was used to analyze the predictive value of various indicators for PAH secondary to frequent acute exacerbation of COPD.Results There were no statistical differences between the two groups in gender,age,course of disease and smoking index(P>0.05).The levels of neutrophil count(NEUT),neutrophil/lymphocyte ratio(NLR)and N-terminal brain natriuretic peptide(NT-pro BNP)in PAH group were higher than those in non-PAH group(P<0.05).Lymphocyte count(LY)and white protein level in PAH group were lower than those in non-PAH group,and the right ventricular diameter was larger than that in non-PAH group(P<0.05).There were no statistical differences in the levels of white blood cell(WBC),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and procalcitonin(PCT)between the two groups(P>0.05).Multivariate logistic regression analysis showed that NLR>5.61、NT-pro BNP>590.61 ng·L-1 were independent risk factors for PAH secondary to frequent acute exacerbation of COPD(P<0.05).The ROC curve showed that the area under the curve of NLR and NT-pro BNP predicting PAH secondary to frequent acute exacerbation of COPD were 0.688 and 0.789,respectively.Conclusion NLR>5.61,NT-pro BNP>590.61 ng·L-1 are independent risk factors for PAH secondary to frequent acute exacerbation of COPD,and they have high predictive value.
作者
王潇
许爱国
WANG Xiao;XU Ai-guo(Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《河南医学研究》
CAS
2020年第31期5782-5785,共4页
Henan Medical Research
关键词
频繁急性加重的慢性阻塞性肺疾病
肺动脉高压
N端脑钠肽前体
中性粒细胞/淋巴细胞
多普勒超声心动图
frequent acute exacerbation of chronic obstructive pulmonary disease
pulmonary hypertension
N-terminal brain natriuretic peptide
neutrophil/lymphocyte ratio
Doppler echocardiography
