摘要
目的 探讨藏族慢性阻塞性肺疾病急性加重期(AECOPD)患者呼出气一氧化氮(FeNO)水平增高的临床预测因素。方法 回顾性收集2018年6月-2023年2月三六三医院收治的藏族AECOPD患者FeNO水平,及其人口学特征、生活环境、个人史、家族史、肺功能和血检指标。将患者分为高FeNO组(FeNO>25ppb)和低FeNO组(FeNO≤25ppb),行单因素组间比较,选取差异性变量,进一步采用广义倾向性得分加权分析,评价其与FeNO水平的关联程度。结果 共235例藏族AECOPD患者纳入本次研究,其中高FeNO组71例(30.2%),低FeNO组164例(69.8%)。单因素分析提示,与低FeNO组相比,高FeNO组患者生物燃料的使用时间更长(P<0.001)、目前使用生物燃料者的占比更高(P<0.001),外周血嗜酸性粒细胞(EOS)计数更高(P=0.040),C反应蛋白(CRP)水平更低(P=0.045),目前吸烟人数占比更低(P=0.011),居住海拔更低(P=0.016)。广义倾向性得分加权分析进一步显示,高FeNO组患者目前使用生物燃料者的占比更高(P<0.001),外周血EOS计数更高(P=0.032),身高更高(P=0.016),年龄更大(P=0.037);目前吸烟人数占比更低(P=0.001),居住海拔更低(P=0.023)。结论 本研究发现在藏族AECOPD患者中,使用生物燃料、外周血高EOS计数、较高身材、更大年龄,而非目前吸烟和居住高海拔,可能是高FeNO水平的临床预测因素。
Objective To investigate the clinical predictors of increased FeNO level in Tibetan acute exacerbation of chronic obstructive pulmonary disease(AECOPD) patients.Methods The Tibetan AECOPD patients admitted to 363 Hospital from June 2018 to February 2023 were included in this study.FeNO levels,demographic characteristics,living environment,personal history,family history,lung function,and blood test indexes of the patients were collected.The Tibetan AECOPD patients were divided into high FeNO group(FeNO>25ppb) and low FeNO group(FeNO≤25 ppb) as according to the cut-off value 25 ppb.The variables with statistical differences between the high and low FeNO groups and the variables significantly related to FeNO in previous studies were further weighted by generalized propensity scores to evaluate the degree of association with FeNO levels.Results A total of 235 Tibetan patients with AECOPD were included in this study,with 71 patients included in the high FeNO group(30.2%) and 164 patients included in the low FeNO group(69.8%).Compared with the patients of the low FeNO group,patients of the high FeNO group had a longer period of biomass exposure(P<0.001),a higher proportion of current users of biomass(P<0.001),higher levels of eosinophils(P=0.040),lower CRP levels(P=0.045),lower proportion of current smokers(P=0.011) and living at a relative lower altitude(P=0.016).The weighted(generalized) propensity scores further indicated that the Tibetan AECOPD patients of high FeNO level had higher peripheral blood EOS counts(P=0.032),higher stature(P=0.016),older age(P=0.037),higher proportion of current users of biomass(P<0.001),lower proportion of current smokers(P=0.011) and living at a relative lower altitude(P=0.016).Conclusion This study found that in Tibetan AECOPD patients,biomass exposure,increased blood EOS cell count,older age,taller population,but not current smoking and higher living altitude,may be considered as clinical predictors of high FeNO levels.
作者
欧利
彭苒
刘蔺
陈磊
OU Li;PENG Ran;LIU Lin;CHEN Lei(Department of Pulmonary and Critical Care Medicine,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Pulmonary and Critical Care Medicine,363 Hospital,Chengdu 610041,China)
出处
《西部医学》
2024年第1期52-56,共5页
Medical Journal of West China
基金
成都市卫健委医学科研项目(2021133)。
关键词
慢性阻塞性肺疾病急性加重期
呼出气一氧化氮
嗜酸性粒细胞
藏族
广义倾向性得分加权
Acute exacerbation of chronic obstructive pulmonary disease
Fractional exhaled nitric oxide
Eosinophils
Tibetan
Generalized propensity score weighting
