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| SII PNI与支气管扩张症-慢性阻塞性肺疾病重叠综合征的相关性分析 |
| Predictive value of SII and PNI in bronchiectasis-chronic obstructive pulmonary disease overlap syndrome |
| 投稿时间：2022-05-18 |
| DOI：10.3969/j.issn.1000-0399.2023.01.007 |
| 中文关键词: 慢性阻塞性肺疾病 支气管扩张 系统免疫炎症指数 预后营养指数 |
| 英文关键词: Chronic obstructive pulmonary disease Bronchiectasis Systemic immune inflammatory index Prognostic nutritional index |
| 基金项目:白求恩-医学科学研究基金(编号:SC2342EN) |
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| 中文摘要: |
| 目的 探究系统免疫炎症指数(SII)、预后营养指数(PNI)与支气管扩张症-慢性阻塞性肺疾病重叠综合征(BCOS)的相关性。方法 回顾性分析2019年6月1日至2020年5月31日阜阳市人民医院住院收治的331例慢性阻塞性肺疾病急性加重期(AECOPD)患者病历资料,根据HRCT表现,将患者分为慢性阻塞性肺疾病(COPD)组(n=271)和BCOS组(n=60)。比较两组患者临床资料和检验结果的差异,应用二元logistics回归模型分析COPD患者发生支气管扩张的影响因素,采用受试者工作特征(ROC)曲线评估SII、PNI对BCOS的诊断效能。结果 两组患者的年龄、性别、身体质量指数(BMI)等一般资料比较,差异无统计学意义(P＞0.05);BCOS组患者PNI、Hb、FEV1%pred、FEV1/FVC明显低于COPD组,而糖尿病、抗生素使用时间、病程、住院天数、过去1年急性加重次数、总费用、白细胞计数(WBC)、C反应蛋白(CRP)、SII以及纤维蛋白原(FIB)、D-二聚体(DD)均高于COPD组,差异均有统计学意义(P＜0.05);logisitic回归分析显示:SII、铜绿假单胞菌、过去1年急性加重次数均为BCOS呈的危险因素(OR=1.002、4.261、2.237,P<0.05);PNI为BCOS保护因素(OR=0.906,P＜0.05);ROC曲线分析显示SII诊断BCOS的最佳截断值为688.866,灵敏度为83.30%,特异度为64.90%;PNI诊断BCOS的最佳截断值为42.225,灵敏度为76.70%,特异度为63.50%。结论 过去1年急性加重次数、铜绿假单胞菌、SII、PNI是BCOS的独立危险因素,其中SII、PNI对BCOS有较好的诊断价值,在临床诊断中有一定的参考价值。 |
| 英文摘要: |
| Objective To investigate the correlation between systemic immunoinflammatory index (SII), prognostic nutrition index (PNI) and bronchiectasis - chronic obstructive pulmonary disease overlap syndrome (BCOS). Methods Medical records of 331 patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) admitted to Fuyang People's Hospital from June 1, 2019 to May 31, 2020 were retrospectively analyzed. According to HRCT findings, Patients were divided into chronic obstructive pulmonary disease (COPD) group (n=271) and BCOS group (n=60). The difference of clinical data and test results between the two groups was compared. The factors affecting bronchiectasis in COPD patients were analyzed by binary logistics regression model. The diagnostic efficacy of SII and PNI for BCOS was evaluated by receiver operating characteristic (ROC) curve. Results There were no significant differences in age, sex, body mass index (BMI) and other general data between the two groups (P>0.05). PNI, Hb, FEV1%Pred and FEV1/FVC in BCOS group were significantly lower than those in COPD group. Diabetes mellitus, duration of antibiotic use, duration of disease, length of hospital stay, number of acute exacerbations in the past 1 year, total cost, white blood cell count (WBC), C-reactive protein (CRP), SII, fibrinogen (FIB) and D-dimer (DD) were all higher than those in COPD group, with statistical significance (P<0.05). logisitic regression analysis showed that SII, Pseudomonas aeruginosa and the number of acute exacerbations in the past year were all risk factors for BCOS (OR=1.002, 4.261, 2.237, P<0.05). PNI was a protective factor for BCOS (OR=0.906, P<0.05). ROC curve analysis showed that the best cut-off value, sensitivity and specificity of SII diagnosis of BCOS was 688.866, 83.30% and 64.90%, and the best cut-off value, sensitivity and specificity of PNI diagnosis of BCOS was 42.225, 76.70% and 63.50%. Conclusion The number of acute exacerbations, Pseudomonas aeruginosa, SII and PNI in the past year are independent risk factors for BCOS, among which SII and PNI have good diagnostic value for BCOS and have certain reference value in clinical diagnosis. |
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