Zeng X T, Ma X Q, Gu X N, Deng S M, Zhu T F
Department of Respiratory and Critical Medicine, Yixing Hospital affiliated to Jiangsu University, Yixing 214200, China.
Zhonghua Yi Xue Za Zhi. 2020 Nov 3;100(40):3174-3178. doi: 10.3760/cma.j.cn112137-20200612-01836.
To explore correlative factors and construct predictive model of intestinal flora imbalance in patients with acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD). The patients in acute exacerbation stage of COPD (AECOPD) hospitalized in Yixing People's Hospital from January 1 to December 31, 2019 were included. According to the clinical symptoms and results of fecal examination, the subjects were divided into case group (45) and control group (83). Multivariate logistic regression was used to analyze the correlative factors of intestinal flora imbalance in AECOPD patients. The prediction model of intestinal flora imbalance in patients with AECOPD was constructed according to the results of factor logistic regression analysis, and the effectiveness of the prediction model was evaluated by receiver operating characteristic (ROC) curve analysis. The ages of subjects in case group and control group were (76±9) and (74±8) years old, respectively, among which males accounted for 80.0% (36/45) and 69.9% (58/83), respectively. The multivariate logistic regression model analysis showed that serum albumin concentration, frequency of acute exacerbation ≥2 times/year, complicated with chronic cor pulmonale and diabetes mellitus were correlative factors of intestinal flora imbalance in patients with AECOPD. The (95) were 0.98 (0.80-0.97), 3.70 (1.79-11.72), 2.62 (1.46-10.80) and 3.85 (1.17-8.58), respectively. The prediction model of intestinal flora imbalance was logit 3.858-0.13×serum albumin consentration+1.52×acute exacerbation ≥2 times/year+1.379×chronic cor pulmonale+1.155×diabetes mellitus. The area under the ROC curve of this model was 0.847 and the sensitivity and specificity of the prediction model were 88.9% and 71.1%, respectively. Serum albumin, frequency of acute exacerbation ≥2 times/year, complicated with chronic cor pulmonale and diabetes mellitus are correlative factors of intestinal flora imbalance in patients with AECOPD. The predictive model shows high clinical value in predicting intestinal flora imbalance in patients with AECOPD.
探讨慢性阻塞性肺疾病(COPD)急性加重期患者肠道菌群失调的相关因素并构建预测模型。纳入2019年1月1日至12月31日在宜兴市人民医院住院的COPD急性加重期(AECOPD)患者。根据临床症状和粪便检查结果,将研究对象分为病例组(45例)和对照组(83例)。采用多因素logistic回归分析AECOPD患者肠道菌群失调的相关因素。根据因素logistic回归分析结果构建AECOPD患者肠道菌群失调的预测模型,并通过受试者工作特征(ROC)曲线分析评估预测模型的有效性。病例组和对照组研究对象的年龄分别为(76±9)岁和(74±8)岁,其中男性分别占80.0%(36/45)和69.9%(58/83)。多因素logistic回归模型分析显示,血清白蛋白浓度、急性加重频率≥2次/年、合并慢性肺心病和糖尿病是AECOPD患者肠道菌群失调的相关因素。其比值比(95%CI)分别为0.98(0.80 - 0.97)、3.70(1.79 - 11.72)、2.62(1.46 - 10.80)和3.85(1.17 - 8.58)。肠道菌群失调预测模型为logit 3.858 - 0.13×血清白蛋白浓度 + 1.52×急性加重≥2次/年 + 1.379×慢性肺心病 + 1.155×糖尿病。该模型的ROC曲线下面积为0.847,预测模型的敏感度和特异度分别为88.9%和71.1%。血清白蛋白、急性加重频率≥2次/年、合并慢性肺心病和糖尿病是AECOPD患者肠道菌群失调的相关因素。该预测模型在预测AECOPD患者肠道菌群失调方面具有较高的临床价值。