The impact of blood LAR, HBP/ALB and SIRI levels on disease condition and prognosis in patients with AECOPD

doi:10.11958/20260422

Abstract

Abstract:

Objective To analyze the evaluation value of blood lactic acid to albumin ratio (LAR), heparin-binding protein to albumin ratio (HBP/ALB) and systemic inflammatory response index (SIRI) in the judgement of disease condition and prognosis prediction in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A total of 215 patients with AECOPD were divided into the severe group (SAPS-II≥40 points, 73 cases) and the mild group (SAPS-II<40 points, 142 cases) according to the simplified acute physiology score-II (SAPS-II) at admission. Based on the prognosis status at 1 year after discharge, patients were classified into the poor prognosis group (acute exacerbation readmission event or death, 37 cases) and the good prognosis group (178 cases). The general data (gender, age, COPD duration) and laboratory indexes (LAR, HBP/ALB and SIRI at admission) were collected. Multivariate Logistic regression was used to analyze the factor influencing severe AECOPD. Receiver operating characteristic (ROC) curve was adopted to evaluate the diagnostic value of the indexes on severe AECOPD and the predictive value on poor prognosis. Results The age and COPD duration were older or longer in the severe group than those in the mild group (P<0.05), and LAR, HBP/ALB and SIRI at admission were higher in the severe group than those in the mild group (P<0.05). Multivariate Logistic regression analysis showed that high levels of LAR, HBP/ALB and SIRI were independent risk factors for severe AECOPD (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of the combination of LAR, HBP/ALB and SIRI for predicting severe AECOPD was 0.872 (95%CI: 0.821-0.922), which was higher than that of each index (P<0.05). LAR, HBP/ALB and SIRI were higher in the poor prognosis group than those in the good prognosis group (P<0.05). ROC curve analysis showed that the AUC of the combination of LAR, HBP/ALB and SIRI was 0.951 (95%CI: 0.925-0.978) in the predicting poor prognosis, which was higher than that of each index (P<0.05). Conclusion The disease condition and prognosis of patients with AECOPD are closely associated with LAR, HBP/ALB and SIRI at admission. Combined detection of the above indicators can effectively aid in evaluating the disease condition and prognosis.

Key words: pulmonary disease, chronic obstructive, prognosis, acute exacerbation of chronic obstructive pulmonary disease, lactic acid to albumin ratio, heparin-binding protein to albumin ratio, systemic inflammatory response index

CLC Number:

R563

Figures/Tables 8

References 26

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组别	n	年龄/岁	男性	COPD病程/年
轻症组	142	63.71±5.21	85（59.86）	10.56±2.08
重症组	73	67.78±6.03	45（61.64）	12.52±2.16
χ2或t		5.135＊＊	0.064	6.451＊＊
组别	吸烟史	高血压病	糖尿病	高脂血症
轻症组	91（64.08）	48（33.80）	34（23.94）	39（27.46）
重症组	56（76.71）	31（42.47）	21（28.77）	27（36.99）
χ²	3.555	1.557	0.589	2.055

组别	n	年龄/岁	男性	COPD病程/年
轻症组	142	63.71±5.21	85（59.86）	10.56±2.08
重症组	73	67.78±6.03	45（61.64）	12.52±2.16
χ2或t		5.135＊＊	0.064	6.451＊＊
组别	吸烟史	高血压病	糖尿病	高脂血症
轻症组	91（64.08）	48（33.80）	34（23.94）	39（27.46）
重症组	56（76.71）	31（42.47）	21（28.77）	27（36.99）
χ²	3.555	1.557	0.589	2.055

组别	n			WBC/（×10⁹/L）			hs-CRP/（mg/L）			PCT/（μg/L）
轻症组	142			7.52±1.64			19.09±6.41			0.17±0.06
重症组	73			13.57±3.48			65.44±22.09			1.61±0.55
t				14.062^＊＊			17.549^＊＊			22.179^＊＊
组别			PLT/（×10⁹/L）			BASO/（×10⁹/L）			EOS/（×10⁹/L）
轻症组			190.83±41.40			0.03±0.02			0.21（0.08，0.30）
重症组			193.21±48.55			0.03±0.01			0.14（0.02，0.22）
t或Z			0.375			1.189			2.991^＊＊
组别		LAR			HBP/ALB			SIRI
轻症组		0.05±0.01			0.38±0.14			2.35（1.74，3.14）
重症组		0.06±0.02			0.48±0.17			4.55（3.20，5.99）
t或Z		5.167^＊＊			4.626^＊＊			7.332^＊＊

组别	n			WBC/（×10⁹/L）			hs-CRP/（mg/L）			PCT/（μg/L）
轻症组	142			7.52±1.64			19.09±6.41			0.17±0.06
重症组	73			13.57±3.48			65.44±22.09			1.61±0.55
t				14.062^＊＊			17.549^＊＊			22.179^＊＊
组别			PLT/（×10⁹/L）			BASO/（×10⁹/L）			EOS/（×10⁹/L）
轻症组			190.83±41.40			0.03±0.02			0.21（0.08，0.30）
重症组			193.21±48.55			0.03±0.01			0.14（0.02，0.22）
t或Z			0.375			1.189			2.991^＊＊
组别		LAR			HBP/ALB			SIRI
轻症组		0.05±0.01			0.38±0.14			2.35（1.74，3.14）
重症组		0.06±0.02			0.48±0.17			4.55（3.20，5.99）
t或Z		5.167^＊＊			4.626^＊＊			7.332^＊＊

指标	β	SE	Wald χ²	P	OR	OR95%CI
年龄	-0.047	0.026	3.268	0.071	0.954	0.907~1.004
COPD病程	0.142	0.085	2.791	0.095	1.153	0.976~1.362
WBC	0.034	0.059	0.332	0.565	1.035	0.922~1.161
hs-CRP	0.005	0.010	0.250	0.617	1.005	0.986~1.025
PCT	0.192	0.248	0.599	0.439	1.212	0.745~1.970
EOS	-1.652	1.117	2.187	0.139	0.192	0.021~1.711
LAR	52.436	13.081	16.069	<0.001	5.926× 10²²	4.344×10¹¹~ 8.080×10³³
HBP/ALB	5.117	1.339	14.604	<0.001	166.834	12.092~2 301.785
SIRI	0.611	0.106	33.225	<0.001	1.842	1.497~2.268
常数项	-8.327	1.225	46.207	<0.001	0.000	-