Abstract:

Objective　To investigate the changes and clinical significance of lymphocyte ratio (NLR), procalcitonin (PCT), carbohydrate antigen 125 (CA125), and D-dimer (D-D) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) accompanied by respiratory failure. Methods　A total of 160 patients with AECOPD who were admitted to Liaocheng Second People's Hospital from August 2019 to June 2022 were retrospectively selected. According to whether they were combined with respiratory failure, they were divided into an observation group (AECOPD combined with respiratory failure) of 60 cases and a control group (AECOPD non-respiratory failure) of 100 cases. In the observation group, there were 40 males and 20 females; they were 56-85 (67.54±5.67) years old; the course of COPD was 2-16 (5.03±1.49) years. In the control group, there were 65 males and 35 females; they were 57-84 (66.94±5.61) years old; the course of COPD was 2-17 (5.12±1.57) years. The acid-base (pH) values, partial pressures of oxygen (PaO₂) partial pressures of arterial blood carbon dioxide (PaCO₂), percentages of forced expiratory volume in the first second (FEV1%) of the expected value, and serum levels of NLR, PCT, D-D, and CA125 in the two groups were detected and analyzed. t test was applied. Results　The PaCO₂ was higher and the PaO₂, FEV1%, and pH were lower in the observation group than in the control group (t=30.19, 24.53, 18.72, and 27.24; all P<0.05). The serum levels of NLR, PCT, D-D, and CA125 in the observation group were higher than those in the control group (t=39.40, 142.09, 25.56, and 12.45; all P<0.05). The serum levels of NLR, PCT, D-D, and CA125 were negatively correlated with PaO₂ and pH (r=-0.733, -0.666, -0.695, -0.549, -0.762, -0.742, -0.673, and -0.598; all P<0.05), and positively with PaCO₂ (r=0.651, 0.679, 0.784, and 0.684; all P<0.05). Conclusion　The higher the serum levels of NLR, PCT, D-D, and CA125 in patients, the higher the PaCO₂, the lower the PaO₂ and pH, and the more serious the disease. The detection of the above serum factors can be used in clinic to assist clinicians in making auxiliary judgment on the severity of AECOPD patients with respiratory failure, so as to give the patients targeted treatment as early as possible and improve their prognosis.

Key words:

Acute exacerbation of chronic obstructive pulmonary disease, Respiratory failure, Serology, Pulmonary function, Indicators

摘要：

目的　探讨淋巴细胞比值（NLR）、降钙素原（PCT）、糖类抗原125（CA125）、D-二聚体（D-D）在慢性阻塞性肺疾病急性加重期（AECOPD）伴呼吸衰竭患者中的水平变化及临床意义。方法　回顾性选取2019年8月至2022年6月聊城市第二人民医院收治的AECOPD患者160例，依据是否合并呼吸衰竭，将其分为观察组（AECOPD合并呼吸衰竭）60例、对照组（AECOPD非呼吸衰竭）100例。观察组男40例，女20例，年龄56～85（67.54±5.67）岁，COPD病程2～16（5.03±1.49）年。对照组男65例，女35例，年龄57～84（66.94±5.61）岁，COPD病程2～17（5.12±1.57）年。检测两组酸碱（pH）值、血氧分压（PaO₂）、动脉血二氧化碳分压（PaCO₂）水平、第1秒用力呼气容积占预计值百分比（FEV1%）、血清NLR、PCT、D-D、CA125水平，并对上述水平进行分析。统计学方法采用t检验。结果　与对照组比较，观察组PaCO₂水平较高，PaO₂水平、FEV1%、pH值较低（t=30.19、24.53、18.72、27.24，均P<0.05）。观察组血清NLR、PCT、D-D、CA125水平均高于对照组（t=39.40、142.09、25.56、12.45，均P<0.05）。血清NLR、PCT、D-D、CA125水平与PaO₂水平、pH值均呈负相关（r=-0.733、-0.666、-0.695、-0.549、-0.762、-0.742、-0.673、-0.598，均P<0.05），与PaCO₂水平则呈正相关（r=0.651、0.679、0.784、0.684，均P<0.05）。结论　患者体内血清NLR、PCT、D-D、CA125水平越高时，机体内PaCO₂水平就越高，PaO₂水平、pH值则越低，其病情就越严重，临床可通过对上述各血清因子水平进行检测，以辅助临床医师对AECOPD伴呼吸衰竭患者的病情程度进行辅助判断，从而尽早对患者进行针对性治疗，改善患者的预后。

关键词:

慢性阻塞性肺疾病急性加重期, 呼吸衰竭, 血清学, 肺功能, 指标