Value of body mass index and serum albumin in prognostic evaluation in acute exacerbation of chronic obstructive pulmonary disease
- Author:
- No author available
- Journal Title:
- Chinese Journal of Biomedical Engineering
- Issue:
- 3
- DOI:
- 10.3760/cma.j.issn.1674-1927.2018.03.003
- Key Word:
- 肺疾病,慢性阻塞性;人体质量指数;血清白蛋白;预后
Abstract： 目的 探讨体质量指数(BMI)、血清白蛋白(ALB)在慢性阻塞性肺疾病急性加重(AECOPD)预后评估中的作用.方法 收集2013年3月到2016年3月本院呼吸内科收治的测有BMI及ALB的407例AECOPD患者的临床资料.根据患者出院时的存活状态分为存活组和死亡组,通过绘制受试者特征曲线(ROC曲线)计算确定患者住院存活的BMI及血清ALB的界值及敏感度、特异度.通过单因素分析和Logistic回归分析来确定患者住院死亡的危险因素.结果 407例患者中,存活384例,死亡23例,病死率为5.7％,存活组ALB和BMI高于死亡组[分别为ALB:(37.2±4.4)g/L比(32.5±6.1)g/L,BMI:(21.2±3.8)kg/m2比(19.5±3.0)kg/m2,均P<0.05].ROC曲线显示确定患者能好转出院的血清ALB值为34.2 g/L,曲线下面积为0.742(95％可信区间95％CI:0.623～0.861),其敏感度为75.3％、特异度为69.6％;确定患者能好转出院的BMI值为19.9 kg/m2,曲线下面积为0.633(95％CI:0.524～0.741),其敏感度为63.5％、特异度为60.9％.单因素分析显示血清尿素氮>7.14 mmol/L、ALB<34.2 g/L、BMI<19.9 kg/m2、合并有慢性心功能不全及肾功能不全、pH<7.35、PaO2<60 mmHg(1 mmHg=0.133 kPa),PaCO2>50 mmHg是患者住院死亡的危险因素.Logistic回归分析显示显示ALB>34.2 g/L(OR=0.17,95％CI:0.06～0.45),BMI>19.9 kg/m2(OR=0.26,95％CI:0.09～0.73)是患者住院死亡的保护性因素,而合并慢性心功能不全(OR=6.80,95％CI:2.54～18.25),及肾功能不全(OR=5.97,95％CI:1.94～18.35)是患者住院死亡的危险因素.结论 ALB>34.2 g/L及BMI>19.9 kg/m2是AECOPD患者住院死亡的保护性因素.
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