| 李 阳,真 滢,陈曦阳光.胸部血管CT参数联合PLR、IL-17对慢性阻塞性肺疾病急性加重期并发肺动脉高压患者预后的评估价值[J].,2025,(18):2933-2940 |
| 胸部血管CT参数联合PLR、IL-17对慢性阻塞性肺疾病急性加重期并发肺动脉高压患者预后的评估价值 |
| Evaluate Value of Chest Vascular CT Parameters Combined with PLR and IL-17 for the Prognosis of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Pulmonary Hypertension |
| 投稿时间：2025-05-11 |
| DOI：10.13241/j.cnki.pmb.2025.18.008 |
| 中文关键词: 肺动脉高压 慢性阻塞性肺疾病急性加重期 胸部血管CT参数 血小板与淋巴细胞比值 白细胞介素-17 预后 评估价值 |
| 英文关键词: Pulmonary hypertension Acute exacerbation of chronic obstructive pulmonary disease Chest vascular CT parameters Platelet-to-lymphocyte ratio Interleukin-17 Prognosis Evaluate value |
| 基金项目:南平市科技计划项目（N2023J038） |
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| 中文摘要: |
| 摘要 目的：探讨胸部血管计算机断层扫描（computerized tomography, CT）参数联合血小板与淋巴细胞比值（platelet-to-lymphocyte ratio, PLR）、白细胞介素（Interleukin, IL）-17对慢性阻塞性肺疾病急性加重期（acute exacerbation of chronic obstructive pulmonary disease, AECOPD）并发肺动脉高压患者预后的评估价值。方法：前瞻性选取2023年2月至2024年6月我院收治的92例AECOPD合并肺动脉高压患者为研究对象，根据预后不同分为预后不良组（n=41）和预后良好组（n=51）。对比两组胸部血管CT参数、PLR、IL-17指标。采用多因素Logistic回归分析AECOPD合并肺动脉高压患者预后的影响因素，采用受试者工作特征（receiver operating characteristic, ROC）曲线分析胸部血管CT参数、PLR、IL-17对AECOPD合并肺动脉高压患者预后的评估价值。结果：92例AECOP合并肺动脉高压患者，有41例患者再次入院治疗，预后不良发生率为44.57%。预后不良组患者的年龄、病程高于预后良好组（P<0.05）。预后不良组患者的升主动脉直径（ascending aortic diameter, AAD）、主肺动脉直径（main pulmonary artery diameter, MPAD）、降主动脉直径（descending aortic diameter, DAD）、PLR、IL-17指标高于预后良好组（P<0.05）。多因素Logistic分析显示，MPAD、AAD、DAD、IL-17、PLR升高及年龄高、病程长是AECOPD并发肺动脉高压患者预后不良的危险因素。ROC曲线分析显示，胸部血管CT参数MPAD、AAD、DAD与PLR、IL-17联合评估AECOPD合并肺动脉高压预后的曲线下面积（area under the curve, AUC）为0.923，显著高于各指标单独评估。结论：MPAD、AAD、DAD、IL-17、PLR升高及年龄高、病程长是AECOPD并发肺动脉高压患者预后不良的危险因素，胸部血管CT参数与PLR、IL-17联合检测对于AECOPD合并肺动脉高压患者预后有较高的评估价值。 |
| 英文摘要: |
| ABSTRACT Objective: To explore evaluate value of chest vascular computerized tomography (CT) parameters combined with platelet-to-lymphocyte ratio (PLR) and Interleukin (IL)-17 for the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with pulmonary hypertension. Methods: 92 patients with AECOPD complicated with pulmonary hypertension admitted to our hospital from February 2023 to June 2024 were prospectively selected as the research objects, and they were divided into poor prognosis group (n=41) and good prognosis group (n=51) according to the different prognosis. The chest vascular CT parameters, PLR and IL-17 indicators of the two groups were compared. Multivariate Logistic regression analysis were used to analyze the influencing factors of prognosis in patients with AECOPD complicated with pulmonary hypertension. The receiver operating characteristic (ROC) curve was used to analyze the evaluate value of chest vascular CT parameters, PLR and IL-17 for the prognosis of patients with AECOPD complicated with pulmonary hypertension. Results: Among 92 patients with AECOPD complicated with pulmonary hypertension, 41 patients were readmitted for treatment, and the incidence of poor prognosis was 44.57%. The age and disease duration of patients in poor prognosis group were higher than those in good prognosis group (P<0.05). The ascending aortic diameter (AAD), main pulmonary artery diameter (MPAD), descending aortic diameter (DAD), PLR and IL-17 in poor prognosis group were higher than those in the good prognosis group (P<0.05). Multivariate logistic analysis showed that elevated MPAD, AAD, DAD, IL-17, PLR, advanced age and long disease course were risk factors for poor prognosis in patients with AECOPD complicated with pulmonary hypertension. ROC curve analysis showed that the area under the curve (AUC) of the chest vascular CT parameters MPAD, AAD, DAD combined with PLR and IL-17 for evaluating the prognosis of AECOPD complicated with pulmonary hypertension was 0.923, which was significantly higher than that evaluated by each index alone. Conclusion: Elevated MPAD, AAD, DAD, IL-17, PLR, advanced age and long disease course are risk factors for poor prognosis in patients with AECOPD complicated with pulmonary hypertension, the combined detection of chest vascular CT parameters and PLR, IL-17 has a high evaluating value for the prognosis of patients with AECOPD complicated with pulmonary hypertension. |
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