The Value Of Red Cell Distribution Width And Thyroid Hormone Level In Evaluating The Prognosis Of Patients With AECOPD

Objective To explore the value of thyroid hormone levels and erythrocyte distribution width?RDW?in evaluating the prognosis of acute exacerbation of chronic obstructive pulmonary disease?AECOPD?.Methods From December 2017 to February 2019,118 patients with acute exacerbations of COPD were enrolled in the Second Affiliated Hospital of Qinghai University,Department of Respiratory Medicine,Severe ICU,and Emergency ICU.According to the prognosis of patients,67 patients were classified into good prognosis.51 patients with poor prognosis.Clinical data and data were collected including:age,smoking index,partial pressure of oxygen?PaO₂?,hemoglobin?HGB?,partial pressure of carbon dioxide?PaCO₂?,albumin?ALB?,lymphocyte count?LY?,C-reactive protein?CRP?),body mass index?BMI?,PH,thyroid hormone?TT3,TT4,FT4,TSH?,RDW.Mean±standard deviation??x±s?indicates measurement data,and the two groups were compared using independent sample t test or chi-square test.Logistic regression analysis was performed on the clinical indicators of P<0.05.ROC analysis was performed on thyroid hormone and RDW indicators,and the Yoden index was calculated to obtain sensitivity and specificity.Results 1.General information such as:patient gender,age,smoking index,BMI,no significant difference between the group with good prognosis and poor prognosis,P>0.05Clinical indicators ALB,NE,CRP,BMI,PH,and PaCO₂ were statistically significant between the two groups,P<0.05.2.The P<0.05 index in the independent sample test was used as the independent variable,and the prognosis was the dependent variable.Further logistic regression analysis showed that the ALB,CRP and PaCO₂ indicators were risk factors for prognosis.3.The levels of TT₃,TT₄,FT₄,TSH and RDW in the serum of the two groups were analyzed.There were statistically significant differences of TT₃,TT₄,FT₄ and RDW between the two groups,P<0.05.It is suggested that it is related to the poor prognosis of AECOPD patients.4.ROC curve analysis of TT₃,TT₄,FT₄,RDW indicators,TT₃,RDW two clinical indicators,the results have a certain value in the assessment of disease prognosis,TT₃ level assessment of AECOPD prognosis threshold value of0.28 ng/ml,sensitivity 68.3%,specificity 76.6%.The critical value of RDW in evaluating the prognosis of AECOPD was 15.73%,with a sensitivity of 57.2%and a specificity of 75.1%.Conclusion1.TT₃,TT₄,FT₄ and RDW are related to the poor prognosis of AECOPD patients.2.The indexes of TT₃ and RDW have certain value in evaluating the prognosis of patients with AECOPD.3.ALB,CRP and PaCO₂ are risk factors for poor prognosis in patients with AECOPD.