Diagnostic model of syndrome differentiation in acute exacerbation of chronic obstructive pulmonary disease in the elderly
Objective It is to study the correlations of the clinical manifestations and laboratory test indexes with syn-drome of external cold and internal drink,syndrome of phlegm-heat congesting in lung,and phlegm-dampness obstructing lung in acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and to construct models of differential di-agnosis to assist the objectivization of syndrome differentiation.Methods The clinical data of 110 elderly AECOPD patients with with syndrome of external cold and internal drink,syndrome of phlegm-heat congesting in lung,and phlegm-dampness obstructing lung treated in the Respiratory Department of Beijing Geriatric Hospital from November 2017 to December 2019 were retrospectively analyzed,and 68 elderly AECOPD patients with the above 3 syndromes enrolled in December 2020 were prospectively analyzed.The correlations of clinical manifestations,physicochemical data with syndrome types were an-alyzed by one-way intergroup comparison and Logistic LR regression,and stepwise discriminant analysis of the screened rel-evant indexes was carried out by Fisher's discriminant method to construct the diagnostic discriminant model for the diagno-sis of the syndrome of external cold and internal drink,syndrome of phlegm-heat congesting in lung,and phlegm-dampness obstructing lung in the elderly patients with AECOPD.The syndrome types of the newly enrolled patients were prospectively analyzed,the results of the corresponding indicators were also substituted into the syndrome diagnostic discrimination model to compare the consistency to further validate its accuracy.Results According to the clinical data,physicochemical indexes and Logistic results of 110 AECOPD patients,6 variables[(fever,moist crackles,lower limb edema,white blood cell count(WBC),C-reactive protein(CRP),modified Medical Research Council(mMRC)]were screened for discriminant analysis,and the discriminative functions of syndrome of external cold and internal drink,syndrome of phlegm-heat conges-ting in lung,and phlegm-dampness obstructing lung were created in the elderly patients with AECOPD,and the accuracy rate of the model was87.5%.The results of the corresponding indicators in68 newly enrolled AECOPD patients were sub-stituted into the discriminant function and the accuracy was found to be 88.8%.Conclusion Fever,moist crackles,lower limb edema,WBC,CRP,and mMRC are the key index variables for the differentiation of syndrome of external cold and in-ternal drink,syndrome of phlegm-heat congesting in lung,and phlegm-dampness obstructing lung,and the three discrimi-native models based on the key variables are highly accurate,which is of great significance for the identification and classi-fication of AECOPD.
acute exacerbation of chronic obstructive pulmonary diseaseelderlysyndrome typeFisher's discrimi-nant methoddiagnostic model
NETL
NSTL
万方数据
