血清NLR、TNF-α、D-D联合检测对慢性阻塞性肺疾病患者临床预后的预测价值OA
Predictive Value of Combined Detection of Serum NLR,TNF-α,and D-D Levels for Clinical Prognosis in Patients with Chronic Obstructive Pulmonary Disease
目的:分析血清中性粒细胞/淋巴细胞比值(NLR)、肿瘤坏死因子-α(TNF-α)、D-二聚体(D-D)水平联合检测对慢性阻塞性肺疾病(简称"慢阻肺")患者临床预后的预测价值.方法:选取我院2022年1月-2024年2月收治的200例慢阻肺患者为研究对象,另选取同期健康体检者为对照组(n=200),根据患者住院期间预后生存情况分为预后良好(n=163)与预后不良(n=37).对比2组临床一般资料及血清NLR、TNF-α、D-D水平;对比不同预后患者临床治疗方式及并发症;Logistic回归分析慢阻肺患者预后不良影响因素;分析血清NLR、TNF-α、D-D水平对预后不良的预测价值.结果:研究组血清NLR、TNF-α、D-D水平显著高于对照组(P＜0.05);预后不良者血清NLR、TNF-α、D-D水平均高于预后良好者(P＜0.05);预后良好者机械通气治疗及肺心病发生占比显著低于预后不良者(P＜0.05);Logistic回归分析显示,机械通气、肺心病及高水平的血清NLR、TNF-α、D-D为患者预后不良的危险因素(P＜0.05);入院时血清NLR、TNF-α、D-D水平联合预测患者预后不良的效能为0.815,最佳敏感度、特异度分别为81.08％、80.37％.结论:慢阻肺患者血清NLR、TNF-α、D-D水平变化可作为评估慢阻肺患者预后的有效指标,其高表达为患者预后不良的危险因素,加强对其跟踪及监测,有利于病情控制.
Objective:To analyze the predictive value of combined detection of serum neutrophil-to-lymphocyte ratio(NLR),tumor necrosis factor-α(TNF-α),and D-dimer(D-D)levels for the clinical prognosis of patients with chronic obstructive pulmonary disease(Abbreviation:"COPD.").Methods:Two hundred patients with COPD admitted to our hospital from January 2022 to February 2024 were selected as the study subjects,and those who had health checkups in the same period were selected as the control group(n=200)and were divided into patients with good(n=163)and poor(n=37)prognosis according to their prognostic survival during hospitaliza-tion.The clinical general data and serum NLR,TNF-α and D-D levels of the 2 groups were compared.The clinical treatment methods and complications were compared in patients with different prognoses.Logistic regression analysis of factors affecting the poor prognosis of pa-tients with chronic obstructive pulmonary disease.The predictive value of serum NLR,TNF-α and D-D levels for poor prognosis was ana-lyzed.Results:The levels of serum NLR,TNF-α,and D-D in the study group were significantly higher than those in the control group(P＜0.05).The levels of NLR,TNF-α,and D-D in patients with poor prognosis were higher than those in patients with good prognosis(P＜0.05).The proportion of patients with good prognosis who received mechanical ventilation therapy and pulmonary heart disease was significantly lower than that of patients with poor prognosis(P＜0.05).Logistic regression analysis showed that mechanical ventilation,pulmonary heart disease,and high levels of serum NLR,TNF-α,and D-D were risk factors for poor patient prognosis(P＜0.05).The combined prediction of poor prognosis for patients with high serum NLR,TNF-α,and D-D levels at admission had an efficacy of 0.815,with the best sensitivity and specificity of 81.08％and 80.37％,respectively.Conclusion:Changes in serum levels of NLR,TNF-α,and D-D in patients with COPD can serve as effective indicators for evaluating patient prognosis.Their high expression is a risk factor for poor prognosis in patients.Strengthening tracking and monitoring of these levels is beneficial for control of the disease,aiming to provide a more comprehensive and accurate method for evaluating COPD prognosis in clinical practice.
徐迎莉;李想;杨建华
郑州市第一人民医院呼吸与危重症医学科,河南郑州 450000郑州市第一人民医院呼吸与危重症医学科,河南郑州 450000郑州市第一人民医院呼吸与危重症医学科,河南郑州 450000
医药卫生
慢性阻塞性肺疾病预后中性粒细胞/淋巴细胞比值(NLR)肿瘤坏死因子-α(TNF-α)D-二聚体(D-D)
Chronic obstructive pulmonary diseasePrognosisNeutrophil-to-lymphocyte ratio(NLR)tumor necrosis factor-α(TNF-α)D-dimer(D-D)
《中国药物评价》 2025 (3)
200-203,4
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