关键词:

慢性阻塞性肺疾病, 定量CT, 超敏C反应蛋白/白蛋白比值, 病情程度, 疗效

Abstract:

Objective　To analyze the correlations between quantitative CT parameters of lung lobes, serum high-sensitivity C-reactive protein/albumin ratio (HCAR) levels, and the severity and therapeutic efficacy in patients with chronic obstructive pulmonary disease (COPD). Methods　A retrospective study was conducted on 92 patients with COPD admitted to Second Affiliated Hospital of Zhengzhou University from March 2022 to August 2024. The patients were divided into mild (42 cases), moderate (31 cases), and severe groups (19 cases) based on their disease severity. There was no significant difference in general data among the three groups ( all P>0.05 ).The quantitative CT parameters of lung lobes [CT air trapping index (ATI), low attenuation area percentage (LAA%) of the entire lung volume, and wall area percentage (WA%)] and serum HCAR level were compared among the three groups at admission, and their correlations were analyzed. The levels of each indicator were compared among patients with different treatment effects, and partial regression analysis was used to analyze their correlations with treatment effect and their predictive value for ineffective treatment. One way analysis of variance and t test were used for statistical analysis. Results　The ATI, LAA%, WA%, and serum HCAR levels in the three groups were compared, severe group > moderate group > mild group, with statistically significant differences (F=29.049, 211.037, 95.503, and 26.523, all P<0.05); ATI, LAA%, WA%, and serum HCAR were positively correlated with the severity of disease (r=0.622, 0.671, 0.637, and 0.667, all P<0.001). The ATI, LAA%, WA%, and serum HCAR levels in the ineffective patients were higher than those in the effective patients (t=5.537, 14.983, 3.901, and 5.410, all P<0.05); ATI (OR=3.070, 95%CI 1.541-6.117), LAA% (OR=2.534, 95%CI 1.847-3.477), WA% (OR=3.086, 95%CI 1.416-6.727), and serum HCAR levels (OR=4.085, 95%CI 2.441-6.837) were risk factors for ineffective treatment (all P<0.05). The efficacy of combined prediction for ineffective treatment using the parameters of ATI, LAA%, WA%, and serum HCAR levels was 0.912, which was higher than that of each individual parameter (P<0.05). Conclusions　Both quantitative CT parameters of lung lobes and serum HCAR are associated with the severity of the COPD patients' condition and therapeutic effect. The combined detection of ATI, LAA%, WA%, and serum HCAR levels can improve the sensitivity and specificity in predicting the therapeutic effect, with high clinical application value.

Key words:

Chronic obstructive pulmonary disease, Quantitative computed tomography, High-sensitivity C-reactive protein/albumin ratio, Severity of illness, Therapeutic effect