全身炎症标志物CRP比痰液炎症标志物更能预测慢性阻塞性肺疾病急性加重(AECOPD)的再入院情况。

Systemic Inflammatory Marker CRP Was Better Predictor of Readmission for AECOPD Than Sputum Inflammatory Markers.

作者信息

Jing Zhang, Chun Chang, Ning Shen, Hong Zhu, Bei He, Wan-Zhen Yao

机构信息

Departament of Respiratory Diseases, Peking University Third Hospital, Pequín, China.

Departament of Respiratory Diseases, Peking University Third Hospital, Pequín, China.

出版信息

Arch Bronconeumol. 2016 Mar;52(3):138-44. doi: 10.1016/j.arbres.2015.01.011. Epub 2015 May 20.

Abstract

INTRODUCTION

Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) readmission contributes considerably to the worse outcomes for COPD patients. Predictors for readmission include some socio-demographic variables and the severity of the underlying disease, however, few evidence suggested whether persistently heightened airway or systemic inflammation was related to recurrence of AECOPD. The aim of this study was to evaluate role of airway and systemic inflammatory biomarkers during AECOPD on predicting readmission for AECOPD.

METHODS

Consecutive hospitalized patients with AECOPD were recruited. Inflammatory and clinical indices were evaluated at the day of admission before starting therapy and the day of planned discharge (day 10-14). Predictors for readmission were assessed by binary logistic regression model.

RESULTS

93 patients were included with 51 patients (54.8%) were readmitted due to AECOPD at least once during 1 year following the index admission. The logistic regression model indicated that age (OR=1.072, 95%CI: 1.012-1.135, P=.017), hs-CRP (high sensitive-C reactive protein) at day 14 (OR=1.392, 95%CI: 1.131-1.712, P=.002), CAT value at day 14 (OR=1.12, 95%CI: 1.031-1.217, P=.007) were the independent variables statistically significant in predicting rehospitalization.

CONCLUSION

Systemic inflammatory marker CRP was a better predictor of readmission than sputum inflammatory markers. CAT score and age were also useful to predict readmission.

摘要

引言

慢性阻塞性肺疾病急性加重(AECOPD)再入院对慢性阻塞性肺疾病患者的不良预后有很大影响。再入院的预测因素包括一些社会人口统计学变量和基础疾病的严重程度,然而,很少有证据表明气道或全身炎症持续升高是否与AECOPD复发有关。本研究的目的是评估AECOPD期间气道和全身炎症生物标志物在预测AECOPD再入院中的作用。

方法

招募连续住院的AECOPD患者。在开始治疗前的入院当天和计划出院日(第10 - 14天)评估炎症和临床指标。通过二元逻辑回归模型评估再入院的预测因素。

结果

纳入93例患者,其中51例(54.8%)在首次入院后的1年内因AECOPD至少再入院一次。逻辑回归模型表明,年龄(OR = 1.072,95%CI:1.012 - 1.135,P = 0.017)、第14天的高敏C反应蛋白(hs - CRP)(OR = 1.392,95%CI:1.131 - 1.712,P = 0.002)、第14天的CAT值(OR = 1.12,95%CI:1.031 - 1.217,P = 0.007)是预测再住院的统计学显著独立变量。

结论

全身炎症标志物CRP比痰液炎症标志物更能预测再入院。CAT评分和年龄对预测再入院也有帮助。

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