体重指数在评估内科住院患者肺心病发生中的价值

目的:探讨体重指数在预测内科住院患者肺心病发生中的价值。方法:利用随机数表随机入选解放军第十二医院2012年1月~2012年12月间内科住院患者92例,其中男性47例,女性45例,年龄在22岁~87岁之间。体重指数(Body mass index,BMI)应用公式:BMI=体重/身高2(kg/m2)计算。用酶法检测血清总胆固醇、甘油三酯;葡萄糖氧化酶法测定空腹血糖。结果:与非肺心病组患者比较,肺心病组患者体重指数明显升高(38.96±5.77 vs 29.72±7.879,P0.01);肺心病组患者肺性脑病病史的比率明显升高(26.7%vs 0%,P0.01)。肥胖和极度肥胖的患者合并肺心病病史的比率分别为53.3%、46.7%。多分类Logistic回归分析显示,体重指数与肺心病密切相关。ROC曲线分析显示,体重指数预测肺心病的临界值为BMI32 kg/m2,预测肺心病的ROC曲线下面积为0.860,ROC曲线下面积大于0.7,预测价值较高。Youden指数为0.596,体重指数预测最佳临界值为BMI大于32,诊断特异性为66.2%,敏感性为93.3%,阳性预测值为34.96%,阴性预测值为98.07%。结论:内科住院患者体重指数与肺心病发病率密切相关,体重指数大于32 kg/m2预测内科住院患者肺心病发病有较高的价值。

Value of Body Mass Index in Predicting Pulmonary Heart Disease Onset in Internal Medicine Inpatients

Objective:To study value of body mass index in predicting the incidence rate of pulmonary heart disease onset in internal medicine inpatients.Methods:A total of 92 internal medicine inpatients, aged from 22 to 87 years old, including male 47 and female 45 cases were randomly selected from the Twelfth Central Hospital of PLA during January, 2012 to December, 2012. The body mass index (BMI) was calculated as weight in kilograms divided by height (meters2). Enzyme assay was used for the detection of serum total cholesterol, triglyceride. Fasting serum blood glucose was obtained by glucose oxidase method.Results:Compared to inpatients without pulmonary heart disease, BMI was significantly higher in patients with pulmonary heart disease (38.96 ± 5.77 vs 29.72 ± 7.88, P < 0.01), and the morbidity of pulmonary encephalopathy significantly increased (26.7%vs 0%, P < 0.01). The rates of pulmonary heart disease in obese and very obese patients were 53.3%and 46.7% respectively. Multinomial logistic regression analysis showed that body mass index was closely related to morbidity of pulmonary heart disease. ROC curve analysis disclosed that the critical value of BMI was more than 32 kg/m2 for predicting pulmonary heart disease onset, and ROC area under the curve was 0.860, and the specificity and sensitivity of diagnosis were 66.2 % and 93.3%respectively, and the positive predictive value and negative predictive value was 34.96% and 98.07%respectively.Conclusion:BMI is closely related with the incidence rate of pulmonary heart disease, and BMI greater than 32 kg/m2 has a higher value in predicting the incidence rate of pulmonary heart disease in internal medicine inpatients.