慢性阻塞性肺疾病急性加重期患者继发肺动脉高压的危险因素分析及预测模型构建OA

Objective:To explore the risk factors of secondary pulmonary hypertension(PH)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and to construct a prediction model for analysis.Methods:A total of 100 patients with AECOPD were selected.According to whether they had secondary PH,the patients were divided into an observation group(secondary PH,54 cases)and a control group(AECOPD,46 cases).The influencing factors of secondary PH were analyzed by multivariate Logistic regression.The influencing factors were selected to establish a nomogram model,and the receiver operating characteristic(ROC)curve was used to analyze the prediction of the improved model.Results:The age,neutrophil/lymphocyte ratio(NLR),brain natri-uretic peptide(BNP),and D-dimer levels in the observation group were higher than those in the control group,and the lymphocyte count and FEV1％pred were lower than those in the control group(all P＜0.05).Age,D-dimer,BNP and FEV1％pred were independent influencing factors(all P＜0.05).Based on the above influencing factors,a nomogram model was constructed.After ROC curve analysis,the area under the curve(AUC)of the nomogram model for predicting secondary PH in patients with AECOPD was 0.891(95％CI:0.802～0.950,P＜0.05),which had a good prediction efficiency.Conclusion:The independent risk factors for secondary PH in patients with AECOPD include age,D-dimer,BNP and FEV1％pred.The nomogram prediction model based on these four indicators has good predictive efficiency.