Exploring The Predictive Value Of HCY For AECOPD

Objective:Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is the most common cause of hospitalization and death in patients with COPD(Chronic obstructive pulmonary disease).Clinicians are looking for simple,inexpensive and readily available biomarkers for effective intervention and prognostic assessment.In this study,the propensity score matching(PSM)was used to explore the predictive value of HCY(homocysteine)in acute exacerbation of chronic obstructive pulmonary disease.Methods:Patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)hospitalized in the Second Clinical Hospital of Shanxi Medical University from June 2020 to June 2022 were selected as the experimental AECOPD group and patients with stable chronic obstructive pulmonary disease(COPD)during the same period as the control COPD group.Baseline data(Sex,Age,Smoking,Drinking,Hypertension,Diabetes,History of coronary heart disease)and some commonly used clinical inflammatory indicators(White blood cell count,Red blood cell volume distribution width,Platelet count,Platelet volume distribution width,Absolute value of lymphocytes,Absolute value of monocytes,Absolute value of neutrophils,Neutrophil-lymphocyte ratio,Lymphocyte-monocyte ratio,Monocyte-high density lipoprotein ratio,Procalcitonin,Erythrocyte sedimentation rate,C-reactive protein,Homocysteine)were collected from the two groups.The AECOPD group and the COPD group were matched 1:1 by the nearest neighbor matching method of PSM,and the caliper value was set to 0.2.The processing variables were incorporated into the matching model,and propensity score matching was performed to effectively balance the distribution of confounding variables and make the comparison between groups more balanced.The measurement data conformed to the normal distribution,and independent samples t test was performed.Then,among the selected clinical indicators,one-way analysis of variance was used to screen out the inflammatory indicators reflecting the acute exacerbation of COPD.Variables to construct multivariate analysis models,including absolute value of monocytes,PCT(Procalcitonin),LMR(Lymphocyte-monocyte ratio),MHR(Monocyte-high density lipoprotein ratio),HCY(Homocysteine),multivariate analysis of the absolute value of monocytes,PCT,LMR,MHR,HCY levels in predicting the significance of acute exacerbation of COPD;finally,the receiver operating characteristic(ROC)curve was used to analyze the effect of HCY on COPD Predictive value of acute pulmonary exacerbations.Results:1.Before PSM,there were 76 cases in the AECOPD group and 294 cases in the COPD group.There were no statistical differences in gender,alcohol consumption,hypertension,diabetes,and coronary heart disease between the two groups(p>0.05),but there were statistical differences in age and smoking.(p<0.05).The AECOPD group and the COPD group were matched 1:1 by the nearest neighbor matching method,and the caliper value was set to 0.2.After PSM,there was no statistical difference in baseline data between the two groups(p>0.05).2.After PSM,the HCY,absolute value of monocytes,PCT,LMR and MHR in the experimental AECOPD group were higher than those in the control COPD group,with statistical difference(p<0.05).3.Univariate analysis was performed according to some inflammatory indicators after PSM,showed absolute value of monocytes(95%CI 2.626-40.302,p=0.001),PCT (95%CI 1.080-7.591,p=0.035),LMR(95%CI)1.787-16.692,p=0.003),MHR(95%CI0.488-0.843,p=0.003),and HCY(95%CI 1.038-1.153,p=0.001)levels reflected acute exacerbation of COPD.Continuing the above indicators to build a multivariate analysis model,it showed that only the level of HCY(95%CI 1.032-1.144,p=0.002)was meaningful in predicting acute exacerbation of COPD.4.ROC curve analysis showed that the area under the curve of HCY for the predictive value of COPD exacerbation was 0.084(95%CI 0.773-0.907,p<0.001).Conclusion:1.Compared with COPD,the absolute value of peripheral blood mononuclear cells,PCT,LMR,MHR,and HCY in AECOPD are higher,but the absolute value of peripheral blood mononuclear cells,PCT,LMR,and MHR have no statistical significance for predicting the acute exacerbation of COPD.2.Studies have shown that the level of HCY in the acute exacerbation stage of COPD is significantly higher than that in the stable stage,and the value of predicting AECOPD is great.HCY can be used as a potential predictor of COPD exacerbation.3.HCY may be involved in the pathogenesis of COPD,and high levels of HCY are an independent risk factor for acute exacerbation of COPD.