首页|营养相关指标与慢性阻塞性肺疾病急性加重期的相关性及预后的预测价值

营养相关指标与慢性阻塞性肺疾病急性加重期的相关性及预后的预测价值

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目的 探究营养状态与慢性阻塞性肺疾病急性加重期患者不良预后的相关性，评估营养相关指标对AECOPD预后的预测价值，旨在发现比传统指标更具优势的预后指标。方法 回顾性分析2021年1月至2023年1月于兰州大学第一附属医院就诊的657例AECOPD患者资料，根据预后分为预后良好组和预后不良组，计算新型营养相关指标系统性免疫炎症营养指数(SIINI)、HALP评分(HALP)、预后营养指数(PNI)、淋巴细胞计数/高密度脂蛋白比值(LHR)和低密度脂蛋白/淋巴细胞计数比值(LLR)，分析影响患者预后的危险因素，并评估营养相关指标预测AECOPD患者不良预后的预测价值。结果 预后不良组白蛋白(ALB)、淋巴细胞(LYM)计数、血小板(PLT)、高密度脂蛋白胆固醇(HDL-C)、PNI、HALP较低，而吸烟人数占比、中性粒细胞(NEUT)计数、SIINI、LLR较高，住院时间更久、出院后1年内更易出现频繁急性加重、出院后1年内更可能因急性加重再次入院(P＜0。05)。新型营养指标SIINI、PNI、HALP、LHR、LLR预测AECOPD预后不良的临界值为210。58、42。30、27。66、0。95、2。89。LLR、心力衰竭是预测AECOPD患者预后不良的独立危险因素(P＜0。05)，二者联合预测AECOPD患者预后不良的不同受试者工作特征曲线下面积(AUC)为0。777(95％CI 0。743～0。808)。结论 LLR、心力衰竭是AECOPD患者预后不良的独立危险因素，二者联合预测患者不良预后的能力优于其他单一或联合的营养指标。
Correlation of nutrition related indicators with AECOPD and the Predictive value of prognosis
Objective To investigate the correlation between nutritional status and poor prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and to assess the predictive value of nutrition-related indicators for AECOPD prognosis,with the aim of discovering more advantageous indicators than tra-ditional ones prognostic indicators.Methods Data of 657 patients with AECOPD treated in the First Affiliated Hos-pital of Lanzhou University from January 2021 to January 2023 were retrospectively analyzed and divided into good prognosis group and poor prognosis group according to prognosis.New nutrition-related indexes such as Systemic im-munoinflammatory Nutrition index(SIINI),HALP score(HALP),prognostic nutrition index(PNI),lymphocyte count/high density lipoprotein ratio(LHR)and low density lipoprotein/lymphocyte count ratio(LLR)were calculat-ed to analyze the risk factors affecting the prognosis of patients.To evaluate the predictive value of nutrition-related indexes in predicting poor prognosis of AECOPD patients.Results The poor prognosis group had lower albumin(ALB),lymphocyte(LYM)count,platelet(PLT),high density lipoprotein cholesterol(HDL-C),PNI and HALP,while the higher percentage of smokers,neutrophil(NEUT)count,SIINI,and LLR were associated with longer hos-pitalization,more frequent acute exacerbations were more likely to occur within 1 year of discharge and readmission for acute exacerbations was more likely within 1 year of discharge(P＜0.05).The critical values of the novel nutri-tional indicators SIINI,PNI,HALP,LHR,and LLR for predicting poor prognosis in AECOPD were 210.58,42.30,27.66,0.95,and 2.89.LLR and heart failure were independent risk factors for predicting poor prognosis of patients with AECOPD(P＜0.05),and the combination of both of them predicted The Area Under the Working Characteristic Curve(AUC)for different subjects with poor prognosis was 0.777(95％CI 0.743～0.808).Conclusion LLR and heart failure are independent risk factors for poor prognosis in AECOPD patients,and the combination of the two predicts poor patient prognosis better than any other single or combined nutritional indicator.

Acute exacerbation of chronic obstructive pulmonary diseasenutritional indicatorsprognosispredictive value

许金回、岳红梅、刘苗苗、李雅亭、武兴东、朱浩斌

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730000 甘肃兰州,兰州大学第一临床医学院

730000 甘肃兰州,兰州大学第一医院呼吸与危重症医学科

慢性阻塞性肺疾病急性加重期 营养指标 预后 预测价值

2025

10.3969/j.issn.1009-6663.2025.01.006

临床肺科杂志
安徽医科大学 解放军第105医院

临床肺科杂志

影响因子：1.42
ISSN：1009-6663
年,卷(期)：2025.30(1)