实用老年医学

实用老年医学 ›› 2023, Vol. 37 ›› Issue (2): 164-167.doi: 10.3969/j.issn.1003-9198.2023.02.014

• 临床研究 • 上一篇    下一篇

肺部CT与NLR、ALB联合预测老年COPD合并Ⅱ型呼吸衰竭病人临床预后的价值

唐兰, 于佳, 梅凯   

  1. 611130 四川省成都市,成都中医药大学附属第五人民医院(成都中医药大学第二临床医学院)老年医学科
  • 收稿日期:2022-03-25 出版日期:2023-02-20 发布日期:2023-02-27
  • 基金资助:
    四川省医学(青年创新)科研课题(S20089)

Value of lung CT combined with NLR and ALB in predicting the clinical prognosis of elderly patients with chronic obstructive pulmonary disease combined with type Ⅱ respiratory failure

TANG Lan, YU Jia, MEI Kai   

  1. Department of Geriatrics, Chengdu Fifth People’s Hospital, Chengdu 611130, China
  • Received:2022-03-25 Online:2023-02-20 Published:2023-02-27

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摘要： 目的 探讨分析肺部CT与中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血清白蛋白(ALB)联合预测COPD合并 Ⅱ 型呼吸衰竭病人临床预后的价值。方法 选取2019年12月至2021年12月我院确诊的COPD合并Ⅱ型呼吸衰竭病人108例,随访3个月,根据预后情况将病人分为生存组(97例)和死亡组(11例)。2组均进行肺部CT检查并测定最大吸气末异常容积(Vcin)、最大呼气末异常容积(Cvex),同时检测并比较2组血清NLR、ALB水平;绘制ROC曲线,分析肺部CT联合NLR、ALB预测COPD合并Ⅱ型老年呼吸衰竭病人预后的价值。结果 生存组APACHE Ⅱ评分、PaCO2、Vcin、Cvex及NLR水平均显著低于死亡组(P＜0.05),血清ALB水平显著高于死亡组(P＜0.05)。ROC曲线结果显示, Vcin、Cvex预测COPD合并Ⅱ型呼吸衰竭病人临床预后的AUC分别为0.69、0.65,敏感度和特异度分别为72.56%、66.74%和66.43%、62.59%;NLR、ALB预测的AUC分别为0.68、0.67,敏感度和特异度分别为64.58%、63.67%和61.37%、62.54%; Vcin、Cvex联合NLR、ALB预测的AUC为0.81,敏感度和特异度分别为85.42%、81.39%。结论 肺部CT与NLR、ALB联合预测老年COPD合并Ⅱ型呼吸衰竭病人临床预后的敏感度和特异度均达80%以上,对病人预后的评估具有较高临床应用价值。

关键词: 肺部CT, 中性粒细胞与淋巴细胞比值, 白蛋白, 慢性阻塞性肺疾病, Ⅱ型呼吸衰竭

Abstract: Objective To explore the value of pulmonary CT combined with neutrophil to lymphocyte ratio (NLR) and albumin (ALB) in predicting the clinical prognosis of the elderly patients with chronic obstructive pulmonary disease (COPD) combined with type Ⅱ respiratory failure. Methods A total of 108 COPD patients combined with type Ⅱ respiratory failure diagnosed in our hospital from December 2019 to December 2021 were enrolled and followed up for 3 months. According to the prognosis, the patients were divided into the survival group (97 cases) and the death group (11 cases). Lung CT was performed in all patients to determine the maximum abnormal end-inspiratory volume (Vcin)and the maximum abnormal end-expiratory volume(Cvex), and the level of NLR and serum ALB were collected and compared in the two groups. The value of Vcin, Cvex combined with NLR and ALB in predicting the prognosis of COPD patients with type Ⅱ respiratory failure was analyzed. Results The Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ score and the levels of arterial carbon dioxide partial pressure(PaCO2), Vcin, Cvex and NLR in the survival group were significantly lower and the level of ALB was significantly higher than those in the death group (P<0.05). ROC curve showed that the area under curve (AUC) of Vcin and Cvex for predicting the clinical prognosis of COPD patients combined with type Ⅱ respiratory failure was 0.69 and 0.65, and the sensitivity and specificity were 72.56%, 66.74% and 66.43%, 62.59%, respectively; And the AUC of NLR and ALB for predicting the clinical prognosis were 0.68, 0.67, the sensitivity and specificity were 64.58%, 63.67% and 61.37%, 62.54%, respectively. The AUC of Vcin, Cvex combined with NLR and ALB for predicting the clinical prognosis was 0.81, and the sensitivity and specificity were 85.42% and 81.39%, respectively. Conclusions The sensitivity and specificity of lung CT combined with NLR and ALB in predicting the clinical prognosis of elderly COPD patients with type Ⅱ respiratory failure are more than 80%, which has high application value for clinical evaluation of the prognosis.

Key words: lung computed tomography, neutrophil to lymphocyte ratio, albumin, chronic obstructive pulmonary disease, type Ⅱ respiratory failure

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