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| hs-CRP/PAB维生素D RDW对CAT评分≥10分住院AECOPD患者病情进展的预测增益价值 |
| The predictive gain value of hs-CRP/PAB, vitamin D, and RDW on progression of disease for hospitalized AECOPD patients with a CAT score ≥10 scores |
| 投稿时间：2025-03-18 |
| DOI：10.3969/j.issn.1000-0399.2026.06.013 |
| 中文关键词: 慢性阻塞性肺疾病急性加重期 超敏C反应蛋白/前清蛋白 维生素D 红细胞体积分布宽度 慢性阻塞性肺疾病评估测试评分 |
| 英文关键词: Acute exacerbation of chronic obstructive pulmonary disease High-sensitivity C-reactive protein/prealbumin Vitamin D Red blood cell distribution width Chronic obstructive pulmonary disease assessment test score |
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| 中文摘要: |
| 目的 探究超敏C反应蛋白（hs-CRP）/前清蛋白（PAB）、维生素D、红细胞体积分布宽度（RDW）变化对慢性阻塞性肺疾病评估测试（CAT）评分≥10分住院慢性阻塞性肺疾病急性加重期（AECOPD）患者病情进展的预测增益价值。方法 选取2021年1月至2023年6月华北医疗健康集团邢台总医院196例AECOPD患者（CAT评分≥10分）作为研究对象，根据病情是否进展分为进展组（48例）、未进展组（148例）。比较两组临床资料、hs-CRP/PAB、维生素D、RDW差异，分析hs-CRP/PAB、维生素D、RDW对病情进展的影响因素及其对病情进展的预测价值。结果 进展组肺功能分级Ⅲ占比（39.58%比18.24%）、Ⅳ占比（43.75%比3.38%）高于未进展组（P<0.05）；进展组hs-CRP/PAB(0.24±0.08比0.12±0.04)、RDW[(15.42±2.06)%比（13.31±2.57）%]高于未进展组，维生素D[(19.73±4.66)μg/L比（25.65±7.03）μg/L]低于未进展组（P<0.05）；校正肺功能分级前后，logistic回归分析，hs-CRP/PAB、维生素D、RDW是病情进展的独立危险因素（P<0.05）;hs-CRP/PAB、维生素D、RDW联合预测病情进展的曲线下面积大于hs-CRP/PAB、维生素D、RDW单独预测（P<0.05）；净重新分类指数、综合判别改善指数结果显示，hs-CRP/PAB、维生素D、RDW联合预测患者疾病进展的能力有所改善。结论 hs-CRP/PAB、维生素D、RDW与AECOPD患者病情进展密切相关，3者联合预测患者病情进展价值较高。 |
| 英文摘要: |
| Objective To explore the predictive gain value of changes in high-sensitivity C-reactive protein(hs-CRP)/prealbumin(PAB),vitamin D and red blood cell volume distribution width(RDW) before treatment for the progression of chronic obstructive pulmonary disease assessment test(CAT) score ≥ 10 scores in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods A total of 196 patients with AECOPD(CAT score ≥ 10 scores) in North China Medical Health Group Xingtai General Hospital from January 2021 to June 2023 were selected as the research objects.According to whether the disease progressed, they were divided into the progression group(48 cases) and non-progression group(148 cases). The clinical data,hs-CRP/PAB,vitamin D and RDW were compared between the two groups. The influencing factors of hs-CRP/PAB, vitamin D and RDW on the progression of the disease were analyzed,and the predictive value of hs-CRP/PAB, vitamin D and RDW on the progression of the disease was analyzed. Results The proportion of lung function grade Ⅲ(39.58% vs. 18.24%) and Ⅳ(43.75% vs.3.38%) in the progressive group was higher than that in the non-progressive group(P<0.05).The hs-CRP/PAB(0.24±0.08 vs. 0.12±0.04) and RDW [(15.42±2.06)% vs. (13.31±2.57)%] in the progression group were higher than those in the non-progression group,and the vitamin D [(19.73±4.66) μg/L vs. (25.65±7.03) μg/L] was lower than that in the non-progression group(P<0.05). Logistic regression analysis showed that hs-CRP/PAB, vitamin D and RDW were independent risk factors for disease progression(P<0.05). The area under the curve of hs-CRP/PAB, vitamin D and RDW combined prediction of disease progression was greater than that of hs-CRP/PAB, vitamin D and RDW alone(P<0.05). The results of the net reclassification index and the comprehensive discriminant improvement index showed that the ability of combining hs-CRP/PAB, vitamin D and RDW to predict the disease progression of patients was improved. Conclusion Hs-CRP/PAB, vitamin D and RDW are closely related to the progression of AECOPD patients, and the combination of the three has a high value in predicting the progression of patients. |
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