摘要
目的探究纤维蛋白原等血清学指标在支气管扩张症患者管理中的应用价值。方法回顾性收集并分析2021年7月—2023年6月于南京大学医学院附属金陵医院及附属鼓楼医院就诊的121例支气管扩张症患者的基本信息、血常规、生化、凝血及炎症指标等血清学检查结果。根据患者采集临床样本及信息时的状态,分成稳定期组及急性加重期组,评估纤维蛋白原等血清学指标在识别急性加重期患者中的价值。根据第1秒用力呼气容积占预计值的百分比(forced expiratory volume in the first second as a percentage of predicted value,FEV_(1)%pred)将患者分成FEV_(1)%pred<60%组及FEV_(1)%pred≥60%组,通过分析两组间血清学指标差异筛选出候选生物标志物,并通过相关性及受试者操作特征曲线(receiver operator characteristic curve,ROC曲线)分析进一步探究其识别FEV_(1)%pred<60%患者的能力。结果急性加重期组及FEV_(1)%pred<60%组患者白细胞计数、中性粒细胞计数、血小板计数、C反应蛋白以及纤维蛋白原水平均高于对照组患者,与FEV_(1)%pred呈负相关;白蛋白水平低于对照组,与FEV_(1)%pred呈正相关。ROC曲线分析显示,纤维蛋白原对FEV_(1)%pred<60%患者识别能力最佳(ROC曲线下面积为0.839),优于白细胞计数、中性粒细胞计数、血小板计数、C反应蛋白及白蛋白。当纤维蛋白原>3.35 g/L时,敏感性为91.18%,特异性为71.26%。结论白细胞计数、中性粒细胞计数、血小板计数、C反应蛋白、白蛋白及纤维蛋白原对急性加重期及FEV_(1)%pred<60%的支气管扩张症患者具有一定的识别作用。加强对纤维蛋白原等血清学指标的监测有助于治疗决策的制定及患者个性化管理。
Objective To investigate the application value of fibrinogen and other serological indicators in the management of patients with bronchiectasis.Methods Basic information,serological indicators such as blood routine items,biochemical,blood coagulation,and inflammation index of 121 patients with bronchiectasis in Nanjing Jinling Hospital and Nanjing Drum Tower Hospital from July 2021 to June 2023 were collected.The value of fibrinogen and other serological indicators in identifying patients with acute exacerbation and severely impaired lung function(FEV_(1)%pred<60%)was evaluated.Results The levels of leukocytes,neutrophils,platelets,C-reactive protein and fibrinogen were higher in the patients with acute exacerbation and in the FEV_(1)%pred<60%group,negatively correlated with FEV_(1)%pred.While the level of albumin was higher in the patients of the stable group and FEV_(1)%pred≥60%group,and positively correlated with FEV_(1)%pred.Compared with leukocytes,neutrophils,platelets,C-reactive protein and albumin,fibrinogen demonstrated the best recognition ability for the patients with FEV_(1)%pred<60%(AUC=0.839).The sensitivity of identifying patients with FEV_(1)%pred<60%was 91.18%and the specificity was 71.26%when the level of fibrinogen was over 3.35 g/L.Conclusions Leukocytes,neutrophils,platelets,C-reactive protein,albumin and fibrinogen have shown certain application value in recognition of patients with bronchiectasis in acute exacerbation stage and FEV_(1)%pred<60%.These serological indicators may be helpful in precision treatment and individual management of patients with bronchiectasis.
作者
李媛媛
赵婷婷
苏欣
LI Yuanyuan;ZHAO Tingting;SU Xin(Department of Respiratory and Critical Care Medicine,Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing,Jiangsu 210000,P.R.China;Department of Respiratory and Critical Care Medicine,Nanjing Jinling Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing,Jiangsu 210000,China)
出处
《中国呼吸与危重监护杂志》
CAS
CSCD
2024年第11期777-783,共7页
Chinese Journal of Respiratory and Critical Care Medicine
基金
国家自然科学基金面上项目(82270019)
作者简介
通信作者:苏欣,Email:suxinjs@163.com
