Efficacy of Combined Detection of CRP/FIB,Total Bilirubin,and RDW in Predicting the Therapeutic Response in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Efficacy of Combined Detection of CRP/FIB,Total Bilirubin,and RDW in Predicting the Therapeutic Response in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Objective To analyze the efficacy of combined detection of the ratio of C reactive protein(CRP)to fi-brinogen(FIB)(CRP/FIB ratio),total bilirubin(TBIL),and red blood cell distribution width(RDW)in predicting the therapeutic response in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 265 patients with AECOPD admitted from January 2020 to February 2023 were selected and divided into an effective group(n=241)and an ineffective group(n=24)according to the efficacy.The CRP/FIB ratio,and the levels of TBIL and RDW were compared between the two groups before treatment,and at 3 d and 5 d after treatment.The impact of CRP/FIB ra-tio,TBIL,and RDW levels on the efficacy at 5 d after treatment was analyzed.The receiver operating characteristic(ROC)curve analysis was used to analyze the predictive efficacy of CRP/FIB ratio,TBIL,and RDW alone and in combination on the efficacy of AECOPD at 3 d and 5 d after treatment.Results At 3 and 5 d after treatment,the CRP/FIB ratio and RDW lev-els in the effective group were lower than those in the ineffective group,while the TBIL level was higher than that in the inef-fective group(P＜0.05).Risk analysis showed that at 5 d after treatment,the risk of ineffective treatment in the high-expression CRP/FIB and RDW subgroup was 1.081 and 1.099 times higher than that in the low-expression subgroup,respec-tively(P＜0.05);the risk of ineffective treatment in the high-expression TBIL subgroup was 0.922 times that in the low-expression subgroup(P＜0.05).The ROC curve showed that the area under the ROC curve(AUC)of CRP/FIB,TBIL com-bined with RDW at 3 d after treatment was greater than that of each indicator alone(P＜0.01).At 5 d after treatment,the AUC of CRP/FIB,TBIL combined with RDW was greater than that of each indicator alone(P＜0.01).The AUC of CRP/FIB,TBIL,and RDW in combination was the largest at 5 d after treatment,with a value of 0.932,and its predictive sensitiv-ity was95.83%and specificity was84.23%.Conclusion Changes in CRP/FIB,RDW and TBIL are associated with the therapeutic response of AECOPD,and can be used as markers of therapeutic response.Combined detection of the three can further improve predictive ability and provide reference for early prediction,treatment,and disease stratification of therapeutic efficacy.
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