Hülya Abali, Seda TURAL ÖNÜR, Fatma TOKGÖZ AKYIL, Dila Demir, Sinem Nedime Sökücü, Neslihan Boyraci
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摘要

目的:在慢性阻塞性肺疾病(COPD)的临床过程中,定义为呼吸系统症状恶化(呼吸困难、咳嗽、咳痰)的恶化可能发生,导致预后不良,需要额外治疗。具有成本效益的死亡率预测指标对慢性阻塞性肺病的治疗管理很有价值。我们的目的是研究血清尿酸(UA)和血清尿酸/肌酐比(UCR)是否是慢性阻塞性肺病急性加重期(AECOPD)患者死亡率和低氧血症的预测因子。材料与方法:本横断面研究回顾性分析2014年1月至2018年12月在某胸科参考医院住院的105例AECOPD患者。分析UA和UCR与长期死亡率、低氧血症、合并症、FEV1值以及慢性阻塞性肺疾病(GOLD)阶段诊断、管理和预防的总体策略之间的关系。结果:本研究纳入105例AECOPD患者(男性97例,平均年龄65±9岁),发现高尿酸血症与死亡率有显著相关性(95% CI:1.15 ~ 10.72, p=0.027;95% CI:1.16-4.12, p=0.016),而UCR与死亡率之间无相关性(p=0.051, p=0.053)。低UA水平与低氧血症显著相关(p=0.022),但UCR与低氧血症无相关性(p=0.094)。结论:UA在预测AECOPD患者长期死亡率方面比UCR更重要。我们建议UA可以作为长期死亡率的生物标志物,用于识别需要频繁临床随访和强化治疗管理的高风险COPD患者。
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Kronik Obstrüktif Akciğer Hastalığının Akut Alevlenmesinde Ürik Asit ve Ürik Asitin Kreatinine Oranı Mortalitenin Öngörücüleri midir?
Aim: In the clinical course of Chronic Obstructive Pulmonary Disease (COPD), exacerbations that are defined as worsening of respiratory symptoms (dyspnoea, cough, sputum production) may occur, which causes poor prognosis and require additional treatments. Cost-effective mortality predictors are valuable for the treatment management of COPD. We aimed to investigate whether serum uric acid (UA) and serum uric acid to creatinine ratio (UCR) are predictors of mortality and hypoxemia in patients with acute exacerbations of COPD (AECOPD). Material and Methods: 105 patients with AECOPD who were hospitalized in a reference chest hospital between January 2014 and December 2018 were evaluated retrospectively in this cross-sectional study. The associations between UA and UCR and long-term mortality, hypoxemia, comorbidity, FEV1 value, and Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease (GOLD) stage were analyzed. Results: In the present study including 105 patients with AECOPD (97 males, mean age of 65±9 years), a significant correlation was found between hyperuricemia and mortality (95% CI:1.15-10.72, p=0.027; 95% CI:1.16-4.12, p=0.016, respectively), while no correlation was found between UCR and mortality (p=0.051, p=0.053, respectively). Low UA level was associated with hypoxemia significantly (p=0.022), but no association was observed between UCR and hypoxemia (p=0.094). Conclusion: It appears that UA is more important for predicting long-term mortality in patients with AECOPD than UCR. We suggest that UA can be used as a biomarker of long-term mortality for the identification of high-risk COPD patients that require frequent clinical follow-up and intense treatment management.
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