Relationship between CT pulmonary blood vessel quantitative index and airway immunoinflammatory response in AECOPD patients and its prognostic value analysis
Objective:To explore the relationship between CT pulmonary vascular quantitative indicators and the airway immune inflammatory response in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and its prognostic value.Methods:In total,96 AECOPD patients in our hospital from January 2020 to January 2021 were selected as the research objects.The patients were divided into groups according to the 30-day prognosis:death group(n=17)and survival group(n=79).CT pulmonary vascular quantitative indicators in patients with different prognosis[main pulmonary artery diameter(mPAD),left pulmonary artery diameter(LPAD),right pulmonary artery diameter(RPAD),ascending aorta diameter(AAD),sagittal mPAD,coronary mPAD,axial Oblique mPAD,diameter ratio of main pulmonary artery to ascending aorta(rPA)],airway immune inflammatory response index[tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),interferon-γ(IFN-γ),IL-4]were compared.The correlation between CT pulmonary vascular quantitative indica-tors and airway immune inflammatory response indicators,CT pulmonary vascular quantitative indicators,airway immune in-flammatory response indicators and AECOPD was analyzed.The receiver operating characteristic(ROC)curve was drawn,the predictive value of CT pulmonary vascular quantitative indicators and airway immune inflammatory response indicators and their combined detection in the prognosis of AECOPD patients was evaluated.Results:The mPAD,axial oblique mPAD,co-ronal mPAD,sagittal mPAD,RPAD,LPAD,AAD,rPA,TNF-α,IL-8,IL-4 levels in the death group were significantly higher than those in the survival group,and IFN-γ levels were significantly lower in the survival group than in the death group(P＜0.05).The mPAD,axial oblique mPAD,coronal mPAD,sagittal mPAD,RPAD,LPAD,AAD,rPA were posi-tively correlated with TNF-α,IL-8,IL-4 levels in AECOPD patients,and negatively correlated with IFN-γ levels(P＜0.05).Logistic regression analysis showed that mPAD,axial oblique mPAD,coronal mPAD,sagittal mPAD,RPAD,LPAD,AAD,the levels of rPA,TNF-α,IL-8,IL-4,and IFN-γ were all independent factors affecting the prognosis of AE-COPD patients(P＜0.05).The combined predictive value of CT pulmonary vascular quantitative indicators and airway im-mune inflammatory response indicators for the prognosis of AECOPD patients had an AUC of 0.892.The 30-day survival rate of patients with poor prognosis evaluated by joint testing is lower.Conclusion:CT pulmonary vascular quantitative indicators of AECOPD patients are closely related to airway immune inflammatory response,and clinical detection of CT pulmonary vas-cular quantitative indicators and airway immune inflammatory indicators can predict the prognosis of patients and guide the formulation of clinical diagnosis and treatment plans.
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