| 段云卉,张诗玄,王融,等.慢性阻塞性肺疾病病人营养状况及与肺部感染的相关性[J].安徽医药,2026,30(2):301-304. |
| 慢性阻塞性肺疾病病人营养状况及与肺部感染的相关性 |
| Nutritional status of patients with chronic obstructive pulmonary disease and its correlation with pulmonary infections |
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| DOI：10.3969/j.issn.1009-6469.2026.02.017 |
| 中文关键词: 肺疾病，慢性阻塞性 营养状况 肺部感染 主观全面评定法 相关性 |
| 英文关键词: Pulmonary disease, chronic obstructive Nutritional status Pulmonary infection Subjective global assessment Cor-relation |
| 基金项目:北京市属医院科研培育计划( PZ2018007) |
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| 中文摘要: |
| 目的旨在分析慢性阻塞性肺疾病(COPD)病人营养状况及与肺部感染的关系。方法选取 2022年 9月至 2023年 8月首都医科大学附属北京朝阳医院收治的 COPD病人 120例，采用全自动生化仪检测血清白蛋白( ALB)、前白蛋白( PA)水平；采用主观全面评定法( SGA)进行营养状况评估；依据临床体征及肺部 CT或者痰培养等辅助检查结果，将病人分为未感染组( n= 71)、感染组( n=49)。多因素 logistic回归分析探索 COPD病人发生肺部感染的影响因素；受试者操作特征曲线( ROC曲线)分析营养指标在预测 COPD病人发生肺部感染的效能。结果感染组身体质量指数( BMI)≤18.5 kg/m2病人占比( 61.22%比36.62%)、 SGA评分［( 4.05±1.03)分比( 2.83±0.61)分］较未感染组明显升高( P<0.05)，ALB［( 31.27±4.52)g/L比( 37.31±5.45)g/L］、 PA［( 129.39±16.57)g/L比( 150.21±18.46)g/L］水平较未感染组明显降低( P<0.05)；多因素 logistic回归分析显示， BMI≤18.5 kg/m2占比、 SGA评分升高是影响 COPD病人发生肺部感染的危险因素( P<0.05)ALB升高、 PA升高是其保护因素( P<0.05)； ALB、PA、SGA评分及三者联合预测 COPD病人发生肺部感染的 AUC及其 95%CI为 0.80(0.72，0.87)0.78(0.69，0.85)、 0.84分别，(0.76，0.90)、 0.92(0.86，0.96)三者联合预测效能显著优于单一指标( Z三者联合 -ALB=3.28、Z三者联合 -PA=4.13三者联合 -SGA评分 =2.78，P=Z、0.001、<0.001、0.005)。结论生肺部感染的 COPD病人 SGA评分升高， ALB、PA水平降低，且三者联合预测 COPD病人发生发，肺部感染的效能较高。 |
| 英文摘要: |
| Objective To explore and analyze the nutritional status of patients with chronic obstructive pulmonary disease (COPD)and its relationship with pulmonary infections.Methods From September 2022 to August 2023, 120 COPD patients admitted to Bei-jing Chaoyang Hospital Affiliated to Capital Medical University were regarded as objects. Fully automated biochemical analyzer was ap-plied to detect serum albumin (ALB) and prealbumin (PA) levels. The Patient-Generated Subjective Global Assessment (SGA) was ap-plied to assess nutritional status. According to the clinical signs of all patients and the results of auxiliary examinations such as lung CTor sputum culture, patients were assigned into an infected group (n=49) and an uninfected group (n=71). Multivariate logistic regressionwas applied to analyze the factors influencing the occurrence of pulmonary infections in COPD patients. The receiver operating charac-teristic curve(ROC curve) was applied to analyze the efficacy of nutritional indicators in predicting the occurrence of pulmonary sensa-tion in COPD patients.Results The proportion of BMI≤18.5 kg/m2 (61.22% vs. 36.62%) and SGA score [(4.05±1.03) points vs. (2.83± 0.61) points] in the infected group were significantly higher than those in the uninfected group (P<0.05), while levels of ALB [(31.27± 4.52) g/L vs. (37.31±5.45)g/L] and PA [(129.39±16.57) g/L vs. (150.21±18.46) g/L] were significantly lower than those in the uninfected group (P<0.05). Multivariate logistic regression showed that the elevated proportion of BMI ≤18.5 kg/m2 and SGA score were risk fac-tors for pulmonary infection in COPD patients (P<0.05), while elevated ALB and PA were protective factors (P<0.05). The AUC and 95% CI of ALB, PA, SGA scores, and their combination in predicting pulmonary infection in COPD patients was 0.80 (0.72, 0.87), 0.78(0.69, 0.85), 0.84 (0.76, 0.90), 0.92 (0.86, 0.96), respectively. The effectiveness of the combined prediction of the three factors was bet-ter than that of a single indicator (Z combination-ALB=3.28, Z combination-PA=4.13, Z combination-SGA score=2.78, P=0.001, <0.001, 0.005). Conclusions COPD patients with pulmonary infection have a higher SGA score and lower ALB and PA levels.The combination of the three has ahigher efficacy in predicting the occurrence of pulmonary infection in COPD patients. |
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