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炎症、营养指标与AECOPD患者合并低蛋白血症的相关性分析

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目的 分析炎症、营养指标与慢性阻塞性肺疾病急性加重期(AECOPD)患者合并低蛋白血症的相关性。方法 回顾性分析2020年1月至2022年9月在厦门大学附属第一医院呼吸与危重症医学科收治的AECOPD患者的病例资料,根据血清白蛋白(ALB)是否低于35 g/L分为低蛋白血症组(n=73)与非低蛋白血症组(n=141)。比较两组临床资料、炎症指标和营养指标,Spearman进行相关性分析,二元logistic回归分析AECOPD患者合并低蛋白血症的影响因素。结果 两组患者年龄、住院时间、体重比较差异均有统计学意义(P<0。05);而性别、过去1年内住院次数、身高,以及合并糖尿病、高血压、冠心病比例比较差异均无统计学意义(P>0。05)。与非低蛋白血症组比较,低蛋白血症组的住院时间更长,C反应蛋白、中性粒细胞与白蛋白比值(NAR)、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)和全身免疫炎症指数(SII)水平更高,预后营养指数(PNI)、体重指数(BMI)、血红蛋白、总蛋白水平更低,差异有统计学意义(P<0。05)。体重、BMI、血红蛋白、总蛋白、PNI与AECOPD患者合并低蛋白血症呈负相关(P<0。05),而年龄、住院时间、C反应蛋白、NAR、NLR、PLR、SII与AECOPD患者合并低蛋白血症呈正相关(P<0。05)。二元logistic回归分析显示,PNI、SII、NLR是AECOPD患者合并低蛋白血症的影响因素。结论 在临床上应重视并及时纠正AECO-P D患者的低蛋白血症状态,改善患者炎症指标和营养状况,预防急性加重。
Correlation analysis of inflammation,nutrition indexes and hypoproteinemia in patients with AECOPD
Objective To analyze the correlation between inflammation,nutritional indicators and hy-poproteinemia in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Meth-ods The clinical data of patients with AECOPD admitted to the Department of Respiratory and Critical Care Medicine of the First Affiliated Hospital of Xiamen University from January 2020 to September 2022 were ret-rospectively analyzed,and the patients were divided into the hypoproteinemia group(n=73)and the non-hy-poproteinemia group(n=141)according to whether the serum albumin(ALB)was lower than 35 g/L.The clinical data,inflammatory indicators and nutritional indicators of the two groups were compared,Spearman correlation analysis was performed,and binary logistic regression analysis was performed to analyze the influ-encing factors of patients with AECOPD complicated with hypoproteinemia.Results There were statistically significant differences in age,length of hospital stay,and body weight between the two groups(P<0.05).There were no significant differences in gender,number of hospitalizations in the past 1 year,height,diabetes,hypertension and proportion of coronary heart disease(P>0.05).Compared with the non-hypoproteinemia group,the hypoproteinemia group had longer hospital stays and higher levels of C-reactive protein,neutrophil/albumin ratio(NAR),neutrophil to lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),and systemic immunoinflammatory index(SII).The prognostic nutritional index(PNI),body mass index(BMI),hemoglo-bin and total protein levels were lower,and the difference was statistically significant(P<0.05).Body weight,BMI,hemoglobin,total protein,PNI and AECOPD patients with hypoproteinemia were negatively cor-related(P<0.05),while age,length of hospital stay,C-reactive protein,NAR,NLR,PLR,SII and AECOPD patients with hypoproteinemia were positively correlated(P<0.05).Binary logistic regression analysis showed that PNI,SII and NLR were the influencing factors of hypoproteinemia in AECOPD patients.Conclusion In clinical practice,attention should be paid to and timely correction of hypoproteinemia in pa-tients with AECOPD,improvement of inflammatory indicators and nutritional status of patients,and preven-tion of acute exacerbation.

acute exacerbation of chronic obstructive pulmonary diseasehypoproteinemiainflamma-tionnutrition

李凤、刘海月、林益华、王佳怡、杨菀臻、郑怡萱、甘仲霖

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西南医科大学公共卫生学院,四川泸州 646099

厦门大学附属第一医院检验科,福建厦门 361000

厦门大学附属第一医院呼吸与危重症医学科,福建厦门 361000

厦门大学公共卫生学院,福建厦门 361000

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慢性阻塞性肺疾病急性加重期 低蛋白血症 炎症 营养

国家自然科学基金青年项目福建省卫生健康科技计划项目2023年福建省厦门市医疗卫生重点项目

822026292021QN01013502Z20234010

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(4)
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