血清白蛋白与球蛋白比值联合血小板与淋巴细胞比值对AECOPD患者出院后1年内再入院的预测价值

摘要 目的：分析慢性阻塞性肺疾病急性加重期（AECOPD）患者出院后1年内再入院的影响因素，同时探讨血清白蛋白与球蛋白比值（AGR）联合血小板与淋巴细胞比值（PLR）对AECOPD患者出院后1年内再入院的预测价值。方法：选取2018年5月～2021年10月期间广东省人民医院收治的261例AECOPD患者，根据出院后1年内是否再入院分为再入院组（n=96）和无再入院组（n=165）。对比两组AGR、PLR。采用单因素及多因素Logistic回归分析AECOPD患者出院后1年内再入院的影响因素。采用受试者工作特征（ROC）曲线分析AGR、PLR对AECOPD患者出院后1年内再入院的预测价值。结果：再入院组的AGR低于无再入院组，PLR高于无再入院组（P<0.05）。AECOPD患者出院后1年内再入院与ADL评分、日均中低强度身体活动时间、家庭氧疗、入院前1年急性加重次数、FEV₁%Pred、抗生素使用时间有关（P<0.05）。多因素Logistic回归分析显示：日均中低强度身体活动时间<2 h、入院前1年急性加重次数≥2次、FEV₁%Pred<50、AGR偏低、PLR偏高是AECOPD患者出院后1年内再入院的危险因素（P<0.05）。ROC曲线分析显示：AGR、PLR联合预测AECOPD患者出院后1年内再入院的曲线下面积（AUC）大于AGR、PLR单独预测。结论：AGR联合PLR对AECOPD患者出院后1年内再入院的预测价值较高。日均中低强度身体活动时间<2 h、入院前1年急性加重次数≥2次、FEV₁%Pred<50、AGR偏低、PLR偏高是AECOPD患者出院后1年内再入院的危险因素。

Predictive Value of Serum Albumin to Globulin Ratio Combined with Platelet to Lymphocyte Ratio for Readmission within 1 Year after Discharge of Patients with AECOPD

ABSTRACT Objective: To analyze the influencing factors of readmission within 1 year after discharge of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and to explore the predictive value of serum albumin to globulin ratio (AGR) combined with platelet to lymphocyte ratio (PLR) for readmission within 1 year after discharge of patients with AECOPD at the same time. Methods: 261 patients with AECOPD who were admitted to Guangdong Provincial People''s Hospital from May 2018 to October 2021 were selected, and they were divided into readmission group(n=96) and non readmission group(n=165) based on whether they were readmission within 1 year after discharge. The AGR and PLR were compared between the two groups, and the influencing factors of readmission within 1 year after discharge of patients with AECOPD were analyzed by univariate and multivariate Logistic regression analysis. The predictive value of AGR and PLR for readmission within 1 year after discharge of patients with AECOPD was analyzed by the receiver operating characteristic (ROC) curve. Results: The AGR of the readmission group was lower than that of the non readmission group, while the PLR was higher than that of the non readmission group (P<0.05). The readmission within 1 year after discharge of patients with AECOPD was related to ADL scores, daily average time of moderate to low intensity physical activity, home oxygen therapy, number of acute exacerbations in the first year before admission, FEV₁% Pred, time of use antibiotic(P<0.05). Multivariate Logistic regression analysis showed that daily average time of moderate to low intensity physical activity less than 2 h, number of acute exacerbations in the first year before admission greater than or equal 2 times, FEV₁%Pred less than 50, low AGR, and high PLR were risk factors for readmission within 1 year after discharge of patients with AECOPD(P<0.05). ROC curve analysis showed that the area under the curve (AUC) predicted by the combination of AGR and PLR for readmission within 1 year after discharge of patients with AECOPD was greater than that predicted by AGR and PLR alone. Conclusion: The predictive value of AGR combine with PLR for readmission within 1 year after discharge of patients with AECOPD are higer. daily average time of moderate to low intensity physical activity less than 2 h, number of acute exacerbations in the first year before admission greater than or equal 2 times, FEV₁%Pred less than 50, low AGR, and high PLR were risk factors for readmission within 1 year after discharge of patients with AECOPD.