Construction and Validation of a Nomogram Model for the Clinical Efficacy of Budesonide-Formot-erol Combined with Pirfenidone Capsules in the Treatment of COPD with Pulmonary Interstitial Fi-brosis
[Objective]To explore the efficacy of budesonide-formoterol combined with pirfenidone capsules in treating Chronic Obstructive Pulmonary Disease(COPD)with pulmonary interstitial fibrosis,and at constructing and validating a nomogram model for predicting clinical efficacy.[Methods]From September 2019 to December 2023,107 patients with COPD combined with pulmonary interstitial fibrosis,who were treated with budesonide-formoterol combined with pirfenidone capsules in the Department of Respiratory and Critical Care Medicine at the First Affiliated Hospital of Henan University,were selected.Based on treatment outcomes,they were divided into an improvement group(markedly effective+effective)and an ineffective group(ineffective).Clinical data and la-boratory results of both groups were analyzed through univariate analysis,and factors of statistical significance were subjected to multivariate regression analysis to construct a nomogram for identifying factors influencing treat-ment outcomes.[Results]Out of the 107 patients included,83 were in the improvement group(77.57％)and 24 in the ineffective group(22.43％).There were no statistically significant differences between the two groups in terms of age,gender,BMI,history of alcohol abuse,diabetes,hypertension,heart rate,white blood cell count,PaO2,PaCO2,lactate,and CRP(P＞0.05).Significant differences were found between the improvement and ineffective groups regarding smoking history,pulmonary function classification,COPD duration,APACHE Ⅱ score,and NT-proBNP(P＜0.05).Multivariate regression analysis revealed that a history of smoking,pulmonary function classification of Ⅲ-Ⅳ,long duration of COPD,high APACHE Ⅱ score,and high NT-proBNP were independent risk factors for ineffective treatment in patients with COPD combined with pulmonary interstitial fibrosis(P＜0.05).A nomogram was constructed,demonstrating good predictive performance.[Conclusion]The risk factors affecting the efficacy of budesonide-formoterol combined with pirfenidone capsules in treating patients with COPD combined with pulmonary interstitial fibrosis were identified as a history of smoking,pulmonary function classifi-cation of Ⅲ-Ⅳ,long duration of COPD,high APACHEⅡ score,and high NT-proBNP.These can serve as pre-dictive tools for the efficacy in patients with COPD combined with pulmonary interstitial fibrosis,providing a ref-erence for clinical treatment decision-making.
Pulmonary Disease,Chronic ObstructivePulmonary FibrosisBudesonide,Formoterol Fumarate Drug CombinationPyridones
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