The Diagnostic Value Of Blood Uric Acid And Uric Acid Creatinine Ratio In The Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective:This study explored the clinical diagnostic value of the above two indicators in the acute exacerbation of chronic obstructive pulmonary disease by jointly detecting the ratio of blood uric acid and uric acid creatinine,and compared with the ratio of neutrophil lymphocytes and fibrinogen.Methods:This study retrospectively collected 159 AECOPD patients who were admitted to the Department of Respiratory Medicine of the First Affiliated Hospital of Nanchang University from January 1,2017 to December 31,2019,and Collect 80 patients with stable COPD who were treated in the respiratory medicine clinic at the same time,,and 100 healthy people who underwent physical examination in our hospital at the same time.Collecting clinical data of patients,measureing serum uric acid creatinine ratio,neutrophil lymphocyte ratio,uric acid,fibrinogen,and compare whether the above indicators of the three groups are different,and evaluate single indicators or combined indicators Diagnostic value for AECOPD patients in the COPD population.The patients with AECOPD were divided into two groups according to whether they had pulmonary heart disease.They were divided into simple AECOPD group and AECOPD with pulmonary heart disease group,then comparing whether the above indexes were different between the two groups of patients.The number of days of hospitalization of AECOPD patients was counted,and then comparing whether the number of days of hospitalization of AECOPD patients was related to the above indicators.Results:(1)There were no differences in gender,age,and smoking history among the 159 patients with AECOPD,88 patients with stable COPD,and 100 patients in the control group.(2)The difference analysis showed that the peripheral blood uric acid,uric acid creatinine ratio,NLR,and fibrinogen levle were significantly higher in AECOPD group than in Stable COPD and the control group,and the peripheral blood uric acid,uric acid creatinine ratio,NLR,and fibrinogen level in Stable COPD group was significantly higher than that of the healthy control group.(3)The ROC curve was used to analyze the diagnostic value of each individual indicator for AECOPD in COPD population.The cut-off points when the Jordan Index is maximum are uric acid 304 umol / L,creatinine ratio of uric acid 4.60,NLR4.94,and fibrinogen 3.89 g / L.The sensitivity ranking is uric acid creatinine ratio> uric acid> NLR> fibrinogen,the corresponding values are 75.5%,60.4%,49.1%,45.3%;specificity ranking is fibrinogen> NLR> uric acid> uric acid creatinine ratio The corresponding values are 79.5%,76.1%,58.0%,and 40.9%.(4)The ROC curve was used to analyze the value of different indicators for the diagnosis of AECOPD.The results showed that the AUC value of uric acid + NLR + fibrinogen was the highest,the sensitivity was 43.4%,and the specificity was 85.7%,which was an improvement over the single indicator.(5)The levels of NLR and urinary creatinine in the AECOPD combined pulmonary heart disease group were significantly higher than those in the AECOPD group alone,with statistical differences,and the other three biomarkers showed no difference.(6)The above indicators only show that the fibrinogen level is correlated with the number of days of hospitalization in AECOPD patients.The peripheral blood fibrinogen level of AECOPD patients who have been hospitalized for more than 1 week is significantly higher than those who have not been hospitalized for more than 1 week.Conclusion:(1)The ratio of blood uric acid to uric acid creatinine increased in patients with COPD,and increased more significantly in patients with AECOPD.(2)The diagnostic efficacy of blood uric acid and uric acid creatinine ratio for the diagnosis of AECOPD is lower than that of NLR and fibrinogen.Joint diagnosis can improve the specificity and overall efficacy of diagnosis,but the diagnostic value is low.(3)Blood uric acid creatinine is more significantly increased than in AECOPD with pulmonary heart disease,and blood uric acid and blood uric acid creatinine ratio are not related to the hospitalization days of AECOPD patients.