Abstract
C-Reactive Protein-Albumin-Lymphocyte Index Predictive Value and Medication Guidance for Acute Exacerbations of Chronic Obstructive Pulmonary Disease with Respiratory Failure
Department of Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi Province 030000, 1Department of Respiratory and Critical Care Medicine, Changzhi People’s Hospital affiliated to Shanxi Medical University, 2Department of Clinical Medicine, Changzhi Medical College, 3Department of Respiratory and Critical Care Medicine, Changzhi People’s Hospital affiliated to Changzhi Medical College, Changzhi, Shanxi Province 046000, China
Correspondence Address:
Wanping Wang, Department of Respiratory and Critical Care Medicine, Changzhi People’s Hospital affiliated to Changzhi Medical College, Changzhi, Shanxi Province 046000, China, E-mail: CZSRMYYHXKYJS@163.com
The correlation between C-reactive protein-albumin-lymphocyte index and the severity of acute exacerbation among chronic obstructive pulmonary disease patients and its association with the use of phlegm-reducing drugs, glucocorticoids, antibiotics and C-reactive protein-albumin-lymphocyte index was explored. 257 acute exacerbation of chronic obstructive pulmonary disease individuals according to the presence and absence of respiratory failure, were selected and were divided into two groups, acute exacerbation of chronic obstructive pulmonary disease with respiratory failure group (n=130) and acute exacerbation of chronic obstructive pulmonary disease without respiratory failure group (n=127). Logistic regression was used to analyze the relationship between C-reactive protein-albumin-lymphocyte index and acute exacerbation of chronic obstructive pulmonary disease severity. To study the predictive ability of C-reactive protein-albumin-lymphocyte index on the severity of acute exacerbation of chronic obstructive pulmonary disease, receiver operating characteristic curve was drawn and we calculated the critical value of C-reactive protein-albumin-lymphocyte. According to the critical value, C-reactive protein-albumin-lymphocyte index <2.74 group (n=187) and C-reactive protein-albumin-lymphocyte index >2.74 group (n=80) were categorized. Chi-square test was used to analyze the relationship between the use of phlegm-reducing drugs, glucocorticoids, antibiotics and C-reactive protein-albumin-lymphocyte index. C-reactive protein-albumin-lymphocyte index of the acute exacerbation of chronic obstructive pulmonary disease with respiratory failure group was significantly lower than that of the acute exacerbation of chronic obstructive pulmonary disease without respiratory failure group (p<0.001); C-reactive protein-albumin-lymphocyte index in both single-factor logistic and multi-factor logistic regression (p<0.05); area under curve value of C-reactive protein-albumin-lymphocyte index was 0.653 (p<0.01), the critical value is determined to be 2.74 based on the value corresponding to the maximum Youden index. The usage rate of phlegm-reducing drugs, glucocorticoids, and antibiotics in the C-reactive protein-albumin-lymphocyte index <2.74 group are significantly higher than those in the C-reactive protein-albumin-lymphocyte index >2.74 group (p<0.05). C-reactive protein-albumin-lymphocyte index is an independent risk factor for acute exacerbation of chronic obstructive pulmonary disease with respiratory failure and has certain value in predicting the severity of acute exacerbation of chronic obstructive pulmonary disease; level of C-reactive protein-albumin-lymphocyte index is significantly related to the use of phlegm-reducing drugs, glucocorticoids and antibiotics.
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