| Objectives:Understand GOLD2017 comprehensive evaluation of COPD and clinical laboratory indicators,and explore the clinical link between comprehensive assessment and laboratory-related indicators,so as to comprehensively understand the progress of chronic obstructive pulmonary disease,guide clinical medication,provide a basis for prognosis,thereby delaying the progress of chronic obstructive lung disease.Methods: We retrospectively analyzed 88 patients with AECOPD who met the inclusion and exclusion criteria,all the cases were recruited in the three respiratory departments of Yanan University Affiliated Hospital from October 2016 to January 2018.We collected CAT scores,MMRC scores,and acute exacerbations per year for each patient.According to the comprehensive evaluation in GOLD2017 guideline,88 patients into group A: low risk,few symptoms,18 cases,group B: low risk,many symptoms,25 cases,group C:high risk,few symptoms,10 cases,group D: High risk,many symptoms,35 cases.The four groups were to collect general clinical indicators(age,male/female,BMI),blood routine indicators(WBC,NEU,NLR,EOS,HB,PLT),inflammatory markers(CRP,PCT),arterial blood gas analysis indicators(PH,PO2,PCO2),coagulation index(D-Dimer),lung function index(FEV1/FVC,FEV1% prediction),inspiration/expiration CT scans index(LV,MLD,EI),through statistical methods,analysis of the characteristics between the four groups of data and comprehensive assessment.Results:1.From the general clinical indicators: A,B,C,D between the four groups in the age,body mass index had statistically difference(P <0.05),the distribution of four groups in the proportion of men and women was not statistically difference(P> 0.05).Further statistical analysis found that the ages of patients in group A and group C,group B and group C were statistically difference(P<0.05).The BMI size of patients in group A and C,group A and D,group C and group D had statistically difference(P < 0.05).In the same risk group,the age and BMI of patients were same in the multiple symptoms and fewer symptoms,In the same symptoms group,the age of the high-risk group was larger than the low-risk group and the BMI was lower than the low-risk group.2.From the blood related indicators: A,B,C,D in the EOS,N / L had statistically difference(P <0.05),in the WBC,NEU,HB,PLT was not statistically difference(P>0.05),further statistical analysis found that: EOS counts in group A and group C,group A and D,group B and group D were statistically difference(P<0.05);Blood NLR in group A and group C,group A and group D,group B and group C,group B and group D were statistically difference(P<0.05).In the same risk group,the EOS and N/L of patients were same in the multiple symptoms and fewer symptoms,In the same symptoms group,the EOS and N/L of the high-risk group was larger than the low-risk group.3.From the inflammatory index: A,B,C,D between the four groups in the CRP,PCT size was statistically difference(P <0.05).Further statistical analysis showed that serum CRP and PCT was a statistically difference in group A and group C,group A and D,group B and D(P<0.05).In the same risk group,the CRP and PCT of patients were same in the multiple symptoms and fewer symptoms,In the same symptoms group,the CRP and PCT of the high-risk group was larger than the low-risk group.4.From the arterial blood gas analysis indicators: A,B,C,D between the four groups in the PCO2 size was statistically difference(P <0.05).In further statistical analysis,the PCO2 in the arterial blood of the patients was higher than in the D group.5.From the coagulation index: A,B,C,D between the four groups in the D-Dimer size had statistically difference(P <0.05),with further statistical analysis: The D-Dimer size in the blood had statistically significant difference in A group and D group,B groupand D group(P<0.05).In the same risk group,the D-Dimer of patients were same in the multiple symptoms and fewer symptoms,In the same symptoms group,the D-Dimer of the high-risk group was larger than the low-risk group.6.Pulmonary function index: there was a statistically difference in the distributionof the severity of pulmonary function GOLD among groups A,B,C,and D(P<0.05).7.inspiration/expiration CT scans index:inspiration/expiration CT scans index(LV,MLD,EI)were statistically difference in different severity of pulmonary function GOLD classification(P<0.05).The LV and MLD were larger in the inspiratory phase than in the expiratory phase and had statistically difference(P<0.05).The EI had the same size before and after the inhalation phase and expiratory phase examination and had no statistically difference(P<0.05).8.Comparing the inspiration and expiration MLD in the diagnostic efficacy of COPD: the area under the ROC curve was greater than 0.5,the area under the inspiration curve was 0.638,and the area under the expiratory curve was 0.755.The specificity at inspiration was 0.638,the sensitivity was 0.688,the specificity during expiration was0.73,and the sensitivity was 0.78.Conclusion:In this study,we observed the comparison and analysis of results of various laboratory clinical common indicators in four groups of AECOPD comprehensive assessment:1.The older patients with chronic obstructive pulmonary disease,the smaller the BMI,the higher the risk of acute exacerbations in COPD.2.Laboratory indicators NLR,EOS,CRP,PCT,D-Dimer can be used as biological markers for the prediction and assessment of acute exacerbations of COPD.The higher of the PCO2,the higher the risk of acute exacerbations and the more severe the symptoms in COPD.3.Carbon dioxide partial pressure cannot assess and predict the risk of acute exacerbation of COPD.4.The more symptoms,and the higher the risk,the more severe the airflow restriction in COPD.5.Expiratory CT scans can also be applied to the clinical diagnosis of chronic obstructive pulmonary disease,and it has a certain value for the diagnosis of chronicobstructive pulmonary disease and the judgment of disease severity. |
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