摘要
目的探讨血乳酸(Lac)、降钙素原(PCT)、D-二聚体(D-D)检测对慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸衰竭患者预后的预测价值。方法回顾性分析2022年1月~2024年6月阜南县人民医院重症医学科收治的46例AECOPD合并呼吸衰竭患者(AECOPD+呼衰组)。根据患者28 d预后分为存活组(n=36)和死亡组(n=10)。另选取同期23例性别、年龄配对的呼吸衰竭但未合并AECOPD的患者(呼衰组)。比较2组血浆Lac、PCT、D-D水平。采用受试者工作特征(ROC)曲线分析Lac、PCT、D-D水平对预后的预测价值。结果AECOPD+呼衰组血浆Lac、PCT、D-D水平为(2.93±0.37)mmol/L、(6.34±1.56)ng/ml、(4.28±1.05)mg/L,均高于呼衰组(2.65±0.30)mmol/L、(4.18±1.05)ng/ml、(3.62±0.93)mg/L,差异有统计学意义(t=3.145、5.986、2.553,P<0.05)。死亡组血浆Lac、PCT、D-D水平为(5.69±0.42)mmol/L、(9.35±2.33)ng/ml、(5.84±1.46)mg/L,均高于存活组(2.16±0.27)mmol/L、(5.50±1.42)ng/ml、(3.85±0.88)mg/L,差异有统计学意义(t=32.197、6.537、5.428,P<0.05)。logistic回归分析显示Lac(OR=2.522,P=0.008)、PCT(OR=1.374,P=0.013)、D-D(OR=1.579,P=0.017)是AECOPD合并呼吸衰竭患者死亡的危险因素。3项指标联合预测AECOPD合并呼吸衰竭患者死亡的灵敏度为93.33%,特异度为91.55%(AUC=0.980,95%CI=0.951~1.000)。结论Lac、PCT、D-D可作为AECOPD合并呼吸衰竭的预测因子,对预后有较高的预测价值。
Objective To investigate the prognostic value of blood lactate(Lac),procalcitonin(PCT),and D-dimer(D-D)in patients with AECOPD and respiratory failure.Methods A total of 46 patients with AECOPD and respiratory failure(AECOPD+respiratory failure group)who were admitted to the Department of Critical Care Medicine at Funan County People's Hospital from January 2022 to June 2024 were retrospectively analyzed.According to the 28-day prognosis,patients were divided into survival group(n=36)and death group(n=10).Meanwhile,23 patients with respiratory failure of gender-and age-matched but without AECOPD(the respiratory failure group)were selected.Plasma Lac,PCT,and D-D levels in the two groups were compared.ROC curves were used to analyze the prognostic value of Lac,PCT,and D-D in patients with AECOPD and respiratory failure.Results Plasma levels of Lac,PCT,and D-D in the AECOPD combined with respiratory failure group[(2.93±0.37)mmol/L,(6.34±1.56)ng/ml,(4.28±1.05)mg/L]were higher than those in the respiratory failure[(2.65±0.30)mmol/L,(4.18±1.05)ng/ml,(3.62±0.93)mg/L](t=3.145,5.986,2.553,P<0.05).Plasma levels of Lac,PCT,and D-D in the death group[(5.69±0.42)mmol/L,(9.35±2.33)ng/ml,(5.84±1.46)mg/L]were higher than those in the survival group[(2.16±0.27)mmol/L,(5.50±1.42)ng/ml,(3.85±0.88)mg/L](t=32.197,6.537,5.428,P<0.05).Logistic regression analysis showed that Lac(OR=2.522,P=0.008),PCT(OR=1.374,P=0.013),and D-D(OR=1.579,P=0.017)were risk factors for death in patients with AECOPD and respiratory failure.The sensitivity and specificity of combination of the three indicators for predicting death in patients with AECOPD and respiratory failure were 93.33%and 91.55%(AUC=0.980,95%CI=0.951~1.000).Conclusion Lac,PCT,and D-D can serve as predictors in patients with AECOPD and respiratory failure,and may provided exhibit high predictive value for prognosis.
作者
孙曌
刘雪玲
崔良文
赵奎
Sun Zhao;Liu Xueling;Cui Liangwen;Zhao Kui(Department of Critical Care Medicine,Funan County People's Hospital,Fuyang 236300,China)
出处
《中华保健医学杂志》
2025年第3期411-414,共4页
Chinese Journal of Health Care and Medicine
基金
安徽省自然科学基金项目(2020085MH251)。
关键词
慢性阻塞性肺疾病急性加重期
呼吸衰竭
血乳酸
降钙素原
D-二聚体
Acute exacerbation of chronic obstructive pulmonary disease
Respiratory failure
Blood lactate
Procalcitonin
D-dimer
