Division of Pulmonary & Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Taiwán, China.
Arch Bronconeumol. 2011 Sep;47(9):427-32. doi: 10.1016/j.arbres.2011.04.011. Epub 2011 Aug 6.
Both BODE score (body mass index, degree of airflow obstruction, functional dyspnea, and exercise capacity) and serum C-reactive protein (CRP) are validated predictors of mortality in patients with chronic obstructive pulmonary disease (COPD). The aim of this study is to investigate the predictive value of combined serum CRP and BODE score for mortality in COPD patients.
A cohort of 114 clinically stable COPD patients was assessed for predictors of longitudinal mortality. Variables included age, gender, current smoking status, pack-years, maximal inspiratory/expiratory pressure, BODE score (body mass index, degree of airflow obstruction, functional dyspnea, and exercise capacity), serum CRP, and fibrinogen. Predictors were assessed by Cox proportional hazards regression model. Survival was estimated by Kaplan-Meier method and log-rank test.
Serum CRP (P=0.005; HR=1.042; 95% CI=1.019-1.066) and BODE score (P=0.032; HR=1.333; 95% CI=1.025-1.734) were independent predictors of survival in the multivariate analysis. The cumulative survival rates of COPD patients were sorted from the worst to the best as following: serum CRP >3mg/L & quartile 3-4; serum CRP >3mg/L & quartile 1-2; serum CRP ≤3mg/L & quartile 3-4; serum CRP ≤3mg/L & quartile 1-2 (P<0.001).
Serum CRP and BODE score are independent predictors of survival in stable COPD patients. Combination of serum CRP and BODE score has higher predictive value in clinical practice.
BODE 评分（体重指数、气流阻塞程度、功能性呼吸困难和运动能力）和血清 C 反应蛋白（CRP）均是慢性阻塞性肺疾病（COPD）患者死亡率的有效预测指标。本研究旨在探讨联合血清 CRP 和 BODE 评分对 COPD 患者死亡率的预测价值。
对 114 例临床稳定的 COPD 患者进行了评估，以确定其死亡率的预测因子。变量包括年龄、性别、当前吸烟状况、吸烟包年数、最大吸气/呼气压力、BODE 评分（体重指数、气流阻塞程度、功能性呼吸困难和运动能力）、血清 CRP 和纤维蛋白原。采用 Cox 比例风险回归模型评估预测因子。采用 Kaplan-Meier 方法和对数秩检验估计生存率。
血清 CRP（P=0.005；HR=1.042；95%CI=1.019-1.066）和 BODE 评分（P=0.032；HR=1.333；95%CI=1.025-1.734）是多变量分析中独立的生存预测因子。COPD 患者的累积生存率从最差到最好排序如下：血清 CRP>3mg/L 且四分位 3-4；血清 CRP>3mg/L 且四分位 1-2；血清 CRP≤3mg/L 且四分位 3-4；血清 CRP≤3mg/L 且四分位 1-2（P<0.001）。
血清 CRP 和 BODE 评分是稳定型 COPD 患者生存的独立预测因子。联合检测血清 CRP 和 BODE 评分对临床实践具有更高的预测价值。
