血清ALB、CRP、FeNO对慢性阻塞性肺疾病急性加重期患者预后不良的预测价值OA
Predictive value of serum ALB,CRP and FeNO for the poor prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease
目的 探讨血清清蛋白(ALB)、C反应蛋白(CRP)、呼出气一氧化氮(FeNO)对慢性阻塞性肺疾病急性加重期(AECOPD)患者预后不良的预测价值.方法 选取2024年2月至2025年4月甘肃省天水市第一人民医院收治的120例AECOPD患者作为AECOPD组.另选取同期在甘肃省天水市第一人民医院体检的120例健康体检者作为对照组.收集所有患者基线资料.检测所有研究对象血清ALB、CRP、FeNO水平.根据AECOPD患者预后情况,将其分为预后良好组与预后不良组.采用多因素Logistic回归分析AECOPD患者预后不良的影响因素.绘制受试者工作特征(ROC)曲线分析血清ALB、hs-CRP、FeNO单独及三者联合对AECOPD患者预后不良的预测价值.结果 AECOPD组血清ALB水平低于对照组,血清CRP、FeNO水平均高于对照组,差异均有统计学意义(P＜0.05).预后良好组77例,预后不良组43例.预后不良组第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、血清ALB水平均低于预后良好组,血清CRP、FeNO水平均高于预后良好组,差异均有统计学意义(P＜0.05).多因素Logistic回归分析结果显示,血清CRP、FeNO水平升高均为AECOPD患者预后不良的危险因素(P＜0.05),血清FVC、FEV1、ALB水平升高均为AECOPD患者预后不良的保护因素(P＜0.05).ROC曲线分析结果显示,血清ALB、CRP、FeNO单独及三者联合预测AECOPD患者预后不良的曲线下面积(AUC)分别为0.820、0.803、0.777、0.927,三者联合预测的AUC大于单独预测的AUC(Z=3.006、3.508、4.005,P＜0.05).结论 血清 ALB、CRP、FeNO 联合检测对 AECOPD 患者预后不良具有较高的预测价值,值得临床推广应用.
Objective To investigate the predictive value of serum albumin(ALB),C reactive protein(CRP)and fractional exhaled nitric oxide(FeNO)on the poor prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 120 patients with AECOPD admitted to Tianshui First People's Hospital from February 2024 to April 2025 were selected as the AECOPD group.At the same time,120 healthy people who underwent physical examination in Tianshui First People's Hospital of Gansu Province were selected as the control group.Baseline data of all patients were collected.The levels of serum ALB,CRP and FeNO were detected in all subjects.According to the prognosis of AECOPD patients,they were divided into good prognosis group and poor prognosis group.Multivariate Logistic regression was used to analyze the influencing factors of poor prognosis in AECOPD patients.The receiver operating charac-teristic(ROC)curve was drawn to analyze the predictive value of serum ALB,hs-CRP,FeNO alone and the combination of the three for poor prognosis in AECOPD patients.Results The serum ALB level of the AE-COPD group was lower than that of the control group,and the serum CRP and FeNO levels were higher than those of the control group,and the differences were statistically significant(P＜0.05).There were 77 cases in the good prognosis group and 43 cases in the poor prognosis group.The levels of forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),and serum ALB in the poor prognosis group were lower than those in the good prognosis group,and the levels of serum CRP and FeNO were higher than those in the good prognosis group,and the differences were statistically significant(P＜0.05).Multivariate Logistic re-gression analysis showed that the increased levels of serum CRP and FeNO were risk factors for poor progno-sis in patients with AECOPD(P＜0.05),and the increased levels of serum FVC,FEV1 and ALB were protec-tive factors for poor prognosis in patients with AECOPD(P＜0.05).ROC curve analysis results showed that the area under the curve(AUC)of serum ALB,CRP,FeNO alone and the combination of the three to predict poor prognosis of AECOPD patients were 0.820,0.803,0.777,0.927,respectively.The AUC of combined prediction was greater than that of individual prediction(Z=3.006,3.508,4.005,P＜0.05).Conclusion The combined detection of serum ALB,CRP and FeNO has a high predictive value for the poor prognosis of AE-COPD patients,which is worthy of clinical application.
陈婷婷;祝俊年;陈娇;杨全福
甘肃中医药大学第一临床医学院,甘肃兰州 730030||甘肃省天水市第一人民医院呼吸与危重症医学科,甘肃天水 741000甘肃省天水市第一人民医院危重症医学科,甘肃天水 741000甘肃中医药大学第一临床医学院,甘肃兰州 730030甘肃省天水市第一人民医院呼吸与危重症医学科,甘肃天水 741000
医药卫生
清蛋白C反应蛋白呼出气一氧化氮慢性阻塞性肺疾病急性加重期预测价值
albuminC reactive proteinexhaled nitric oxideacute exacerbation of chronic obstruc-tive pulmonary diseasepredictive value
《检验医学与临床》 2026 (17)
2305-2310,2317,7
甘肃省科技计划项目(23JRRA0984).
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