| ObjectiveTo investigate the diagnostic value of uric acid and uric acid/creatinine levels in peripheral blood for assessment of illness degree,nutritional status,prognosis,life quality of patients in acute exacerbation of chronic obstructive pulmonary disease,providing scientific experimental basis data for clinic.Methods230 cases of inpatient with acute exacerbation chronic obstructive pulmonary diseases from September 2016 to May 2018 were enrolled in Fuyang Peoples Hospital.According to the global initiative for chronic obstructive pulmonary lung disease patients were divided into four groups as group Ⅰ（55 cases,including 36 cases of men and 19 cases of women）,group Ⅱ（55 cases,including 32 cases of men and 23 cases of women）,group Ⅲ（60 cases,including 34 cases of men and 26 cases of women）and group Ⅳ（60 cases,inluding 28 cases of men and 32 cases of women）.Stable stage patients with chronic obstructive pulmonary diseases of 50 cases were recruited as the stable group,inluding 27 cases of men and 23 cases of women.At the same time,50 healthy people who underwent health examination were selected as the control group,inluding 22 cases of men and 28 cases of women.Patients with active tuberculosis,bronchiectasis,asthma,severe arhythimia,unstable angina,malignant tumor,systemic autoimmune disease,pulmonary arterial hypertension,pulmonary fibrosis,ischemic stroke,severe hepatorenal disease,podagra,previous hyperuricemia,secretory metabolic disease（such as hypothyroidism and hyperthyroidism）and cognitive impairment results in the inability to cooperate with the patient being examined were excluded We compared the clinical data,uric acid,the ratio between uric acid and creatinine,arterial partial pressure of oxygen,partial pressure of carbon dioxide,forced expiratory volume in first second/forced vital capacity,forced expiratory volume in first second/expected value,SGRQ,TSF,AMC,ALB,PAB and NRS-2002 of the every group.We analyzed the correlation between groups the uric acid,the ratio between uric acid and creatinine and lung function,arterial blood gases by Pearson correlation analysis,uric acid,the ratio between uric acid and creatinine with the AECOPD patients by ROC,and the correlation of uric acid,the ratio between uric acid and creatinine and the nutrition status of AECOPD patients.Resullts1.The difference in gender and age between the groups was not statistically significant（P>0.05）;Compared with the control group,the BMI of the stable group.group Ⅰ,Ⅱ Ⅲ and Ⅳ was significantly decreased;Compared with the stable group.the BMI of the group Ⅰ,Ⅱ,Ⅲ and Ⅳ significantly were decreased;Compared with the group I,the BMI group Ⅱ,Ⅲ and IV significantly decreased;Compared with the groupⅡ,the BMI of group Ⅲ and IV significantly decreased,all the differences were statistically significant（P<005）,2.Compared with the control group,the UA and UA/Cr of the stable group,groupⅠ,Ⅱ,Ⅲ and Ⅳ were significantly increased;Compared with the stable group,the UA and UA/Cr of group Ⅰ,Ⅱ,Ⅲ and IV significantly increased;Compared with the group L the UA and UA/Cr of group Ⅱ,Ⅲ and Ⅳ significantly increased;Compared with group Ⅱ,the UA and UA/Cr of group Ⅲ and Ⅳ significantly increased,the differences were statistically significant（P<0.05）;3.Compared with the control group.the PaO2 of the stable group,Ⅰ,Ⅱ,Ⅲ and Ⅳgroup was significantly decreased,and the PaCO2 significantly increased;Compared with the stable group,the PaO2 of group Ⅰ,Ⅱ,Ⅲ and Ⅳ significantly decreased,PaCO2 significantly increased;Compared with the group Ⅰ,the PaO2 of the group Ⅱ,Ⅲ and Ⅳsignificantly was decreased,PaCO2 significantly increased;Compared with group Ⅱ,the PaO2 of group Ⅲ and Ⅳ significantly was decreased,and the PaCO2 significantly increased,the difference was statistically significant（P<0.05）;4.Compared with the control group,the FEV1/FVC and FEV1%of the stable group,group Ⅰ,Ⅱ,Ⅲ and Ⅳ were significantly decreased;Compared with the stabl;group,the FEVi/FVC and FEVi%of group Ⅰ,Ⅱ,Ⅲ and Ⅳ signficantly decreased;Compared with group Ⅰ,the FEV1/FVC and FEV1%of group Ⅱ,Ⅲ and Ⅳ significantly decreased;Compared with group Ⅱ,the FEV1/FVC and FEVV1%of group Ⅲ and Ⅳsignificantly decreased,the differences were statistically significant（P<0.05）;5.The Pearson correlation results shewed that there was a significantly positive correlation between UA and PaCO2,there is a significantly negative correlation between UA and PaO2,FEV1/FVC and FEV1%pred（P<0.05）;There is a significantly positive correlation between UA/Cr and PaCO2,there is a significantly negative correlation between UA/Cr and PaO2,FEV1/FVC and FEV1%pred,the difference was statistically significant（P<0.05）;6.Compared with the control group,the ALB,PAB,AMC and TSF of the stable group,group Ⅰ,Ⅱ,Ⅲ and Ⅳ were significantly decreased;Compared with the stable group,the ALB,PAB,AMC and TSF of group Ⅰ,Ⅱ,Ⅲ and Ⅳ significantly decreased;Compared with the A group,the ALE,PAB,AMC and TSF of group Ⅱ,Ⅲ and Ⅳsignificantly decreased;Compared with group Ⅱ,the ALB PAB,AMC and TSF of the group Ⅱ and Ⅳ signficantly decreased,the differences were statistically significant（P<0.05）;7.Compared with the control group,the 6MWT of the stable group,group Ⅰ,Ⅱ,Ⅲand Ⅳ were significantly decreased,the SGRQ significantly increased;Compared with the stable group,the 6MWT of group Ⅰ,Ⅱ,Ⅲ and Ⅳ signficantly decreased,the SGRQ significantly increased;Compared with group Ⅰ,the 6MWT of group Ⅱ,Ⅲ and Ⅳsignificantly decreased,the SGRQ signfficantly increased;Compared with group Ⅱ,the 6MWT of group Ⅲ and Ⅳ significantly decreased,the SGRQ significantly increased,the difference was statistically significant（P<0.05）;8.ROC curve results show that cut point is set as UA≥264.32 μmol/L,the sensitivity of AECOPD is 79.70%the specificity is 81.30%,the area under the curve is 0.720,95%CI is 0.583-0.804;the UA/Cr≥4.78,the sensitivity of AECOPD is 69.20%,the specificity is 74.90%,the area under the curve is 0.673,95%CIis 0.629-0.793;9.Compared with the low UA group and low UA/Cr group,the people of malautrition of the high UA group and high UA/Cr group significantly increased,the difference was statistically significant（P<0.05）.ConclusionThe uric acid and uric acid/creatinine levels in peripheral blood were abnormal in in acute exacerbation chronic obstructive pulmonary disease patients.These changes were of a certain value in evaluating the illness degree and related to malnutrition and poor prognosis of the patients. |
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