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《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2024年04期

页码:

580-584

栏目:

论著

出版日期:

2024-08-25

文章信息/Info

Title:

Correlation analysis between systemic immune-inflammation index and severity of acute exacerbation of chronic obstructive pulmonary disease

作者:

程炜炜¹; 张 青²; 张诚实²; 冯契靓²; 陈荣荣²; 赵云峰²

200125 上海,上海杨思医院呼吸科¹
200126 上海,上海市浦东新区浦南医院呼吸科²

Author(s):

Cheng Weiwei¹;  Zhang Qing²;  Zhang Chengshi²;  Feng Qiliong²;  Chen Rongrong²;  Zhao Yunfeng².

¹Department of Respiratory Disease, Yangsi Hospital, Shanghai 200126, China; ²Department of Respiratory Disease, Punan Hospital, Pudong New Area, Shanghai 200125, China

关键词:

急性加重期; 肺疾病; 慢性阻塞性;  全身免疫炎症指数;  病情严重程度

Keywords:

Acute exacerbation of chronic obstructive pulmonary disease;  Systemic immune-inflammation index;  Severity

分类号:

R563

DOI:

10.3877/cma.j.issn.1674-6902.2024.04.014

摘要:

目的 分析全身免疫炎症指数(systemic immune-inflammation index, SII)与慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease, AECOPD)病情严重程度的相关性。方法 选择2023年3月至2024年3月在上海杨思医院及上海市浦东新区浦南医院呼吸科收治的174例中、重度AECOPD患者为对象,中度AECOPD患者90例为对照组、重度AECOPD患者84例为观察组; 记录患者入院时、入院第10天的血常规、血清C反应蛋白(C-reactive protein, CPR)、血清降钙素原(procalcitonin, PCT)、动脉氧分压(arterial oxygen pressure, PaO₂)、动脉氧二氧化碳分压(partial pressure of carbon dioxide in arterial blood, PaCO₂)、呼吸困难评分,比较两组治疗前、后指标差异,及SII与其他指标相关性。结果 入院时对照组SII(1354.5±324.5)×10⁹/L、血清CRP(60.2±16.4)mg/L、血清PCT(3.26±0.58)ng/ml、pH(7.18±2.11)、PaO₂(55.9±13.8)mmHg、PaCO₂(56.6±16.8)mmHg、氧合指数(266.4±60.2)mmHg、呼吸困难评分(2.54±0.51)分,观察组(1 892.3±511.2)×10⁹/L、(78.3±20.1)mg/L、(7.32±2.21)ng/ml、(7.09±2.16)、(46.5±11.4)mmHg、(76.5±23.4)mmHg、(222.1±45.5)mmHg、(3.44±0.66)分; 入院第10天,对照组SII(667.1±156.1)×10⁹/L、血清CRP(25.4±5.4)mg/L、血清PCT(1.49±0.39)ng/ml、pH(7.34±2.32)、PaO₂(76.2±18.8)mmHg、PaCO₂(45.7±14.2)mmHg、氧合指数(362.8±88.7)mmHg、呼吸困难评分(1.08±0.36)分,观察组(987.2±261.3)×10⁹/L、(33.2±10.9)mg/L、(2.11±0.90)ng/ml、(7.32±2.21)、(66.2±15.3)mmHg、(55.3±17.8)mmHg、(318.3±73.5)mmHg、(2.15±0.59)分。两组入院时和入院第10天,SII、血清CRP、血清PCT、pH、PaO₂、PaCO₂、氧合指数、呼吸困难评分差异有统计学意义(P<0.05); 两组入院时与第10天指标差异有统计学意义(P<0.05)。两组入院时及入院第10天SII与血清CRP、PCT、PaCO₂、呼吸困难评分呈正相关性,与pH、PaO₂、氧合指数呈负相关性。观察组生存74例(88.10%),死亡10例(11.90%); 对照组生存88例(97.78%),死亡2例(2.22%),观察组病死率高于对照组(P<0.05)。结论 SII与AECOPD病情严重程度呈正相关性,病情越重SII越高。

Abstract:

Objective To analyze the correlation between systemic immune-inflammation index(SII)and severity of moderate-severe patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods A total of 174 patients with AECOPD hospitalized in respiratory wards of Shanghai Yangsi Hospital and Shanghai Pudong New District Punan Hospital from March, 2023 to March, 2024 were selected as study participants. According to severity of AECOPD, all the participants were divided into control group(n=90), and observation group(n=84). Routine blood test, serum C-reactive protein(CRP), serum procalcitonin(PCT), arterial blood gas analysis, dyspnea scores, and SII, were recorded for two groups, at admission and 10 days after admission. The abovementioned parameters were compared between two groups, before and after treatment. Correlation between the SII and other parameters was analyzed. Results At the admission, control group SII(1 354.5±324.5)×10⁹/L, CRP(60.2±16.4)mg/L, PCT(3.26±0.58)ng/ml, pH(7.18±2.11), PaO₂(55.9±13.8)mmHg, PaCO₂(56.6±16.8)mmHg, oxygenation index(266.4±60.2)mmHg、dyspnea score(2.54±0.51). observation group(1 892.3±511.2)×10⁹/L,(78.3±20.1)mg/L,(7.32±2.21)ng/ml,(7.09±2.16),(46.5±11.4)mmHg,(76.5±23.4)mmHg,(222.1±45.5)mmHg,(3.44±0.66); 10 days after the admission, control group SII(667.1±156.1)×10⁹/L, CRP(25.4±5.4)mg/L, PCT(1.49±0.39)ng/ml, pH(7.34±2.32), PaO₂(76.2±18.8)mmHg, PaCO₂(45.7±14.2)mmHg, oxygenation index(362.8±88.7)mmHg, dyspnea score(1.08±0.36), observation group(987.2±261.3)×10⁹/L,(33.2±10.9)mg/L,(2.11±0.90)ng/ml,(7.32±2.21),(66.2±15.3)mmHg,(55.3±17.8)mmHg,(318.3±73.5)mmHg,(2.15±0.59). There were statistical differences between pairwise comparison among the control group and observation group, in the SII, serum CRP, serum PCT, pH, PaO₂, PaCO₂, oxygenation index and dyspnea score, at the admission and 10 days after the admission, respectively(P<0.05). The abovementioned parameters at the admission were statistically different from those 10 days after the admission, in each group(P<0.05). The SII was positively correlated with the serum CRP, PCT, PaCO₂ and dyspnea score, whereas negatively correlated with the pH, PaO₂ and oxygenation index, at the admission and 10 days after the admission, for the two groups. In the observation group, 74 cases survived(88.10%), 10 cases death(11.90%). In the control group, 88 cases survived(97.78%), 2 cases death(2.22%), the mortality rate of the observation group was statistically higher than control group(P<0.05). Conclusions There is a definite positive correlation between SII and severity of moderate-severe patients with AECOPD. The severer the AECOPD, the higher the SII.

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备注/Memo

备注/Memo:

基金项目: 上海市浦东新区卫生系统临床特色学科建设资助(PWYts2021-04);
上海市浦东新区卫生系统重点学科建设资助(PWZxk2022-24);
上海市浦东新区卫生系统重点亚专科建设资助(PWZy2020-15)
通信作者: 赵云峰, Email: yfzh71@126.com

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更新日期/Last Update: 2024-08-25