[1]孙真,王英,宋云熙,等.慢性阻塞性肺疾病急性加重期患者继发肺动脉高压的危险因素分析及预测模型构建[J].陕西医学杂志,2026,(9):1208-1212.[doi:DOI:10.3969/j.issn.1000-7377.2026.09.008]
　SUN Zhen,WANG Ying,SONG Yunxi,et al.Risk factors analysis and prediction model construction of secondary pulmonary hypertension in patients with AECOPD[J].,2026,(9):1208-1212.[doi:DOI:10.3969/j.issn.1000-7377.2026.09.008]
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慢性阻塞性肺疾病急性加重期患者继发肺动脉高压的危险因素分析及预测模型构建

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2026年9期
页码:
1208-1212
栏目:
临床研究
出版日期:
2026-09-05

文章信息/Info

Title:
Risk factors analysis and prediction model construction of secondary pulmonary hypertension in patients with AECOPD
作者:
孙真1; 2; 王英2; 宋云熙2; 梁燕2; 刘复州2; 胡桃红1
（1.锦州医科大学火箭军特色医学中心研究生培养基地,北京 100088；2.中国人民解放军火箭军特色医学中心，北京 100088）
Author(s):
SUN Zhen1; 2; WANG Ying2; SONG Yunxi2; LIANG Yan2; LIU Fuzhou2; HU Taohong1
(1.Graduate Training Base of the Rocket Force Specialty Medical Center,Jinzhou Medical University, Beijing 100088,China;2.PLA Rocket Force Characteristic Medical Center,Beijing 100088,China)
关键词:
慢性阻塞性肺疾病急性加重期; 肺动脉高压; 危险因素; 预测模型; 列线图模型; 脑钠肽
Keywords:
AECOPD; Pulmonary hypertension; Risk factors; Prediction model; Nomogram; Brain natriuretic peptide
分类号:
R 563
DOI:
DOI:10.3969/j.issn.1000-7377.2026.09.008
文献标志码:
A
摘要:
目的：探讨慢性阻塞性肺疾病急性加重期（AECOPD）患者继发肺动脉高压（PH）的危险因素，并构建预测模型进行分析。方法：选取100例AECOPD患者，依据是否继发PH将患者分为观察组（继发PH）54例，对照组（单纯AECOPD）46例。继发PH的影响因素以多因素Logistic回归分析。选取影响因素建立列线图模型，利用受试者工作特征（ROC）曲线分析该模型的预测情况。结果：观察组年龄、中性粒细胞/淋巴细胞比值（NLR）、脑钠肽（BNP）、D-二聚体水平高于对照组，淋巴细胞计数、FEV1%pred低于对照组（均P＜0.05）。年龄、D-二聚体、BNP、第1秒用力呼气容积占预计值百分比（FEV1%pred）是独立影响因素（均P＜0.05）。基于上述影响因素构建列线图模型，经ROC曲线分析，该列线图模型预测AECOPD患者继发PH的曲线下面积（AUC）为0.891（95%CI：0.802~0.950，P＜0.05），预测效能较好。〖HT5”XBS〗结论：AECOPD患者继发PH的独立危险因素包括年龄、D-二聚体、BNP、FEV1%pred，基于此4项指标构建的列线图预测模型有良好的预测效能。
Abstract:
Objective:To explore the risk factors of secondary pulmonary hypertension (PH) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD),and to construct a prediction model for analysis.Methods:A total of 100 patients with AECOPD were selected.According to whether they had secondary PH,the patients were divided into an observation group (secondary PH,54 cases) and a control group (AECOPD,46 cases).The influencing factors of secondary PH were analyzed by multivariate Logistic regression.The influencing factors were selected to establish a nomogram model,and the receiver operating characteristic (ROC) curve was used to analyze the prediction of the improved model.Results:The age,neutrophil/lymphocyte ratio (NLR),brain natriuretic peptide (BNP),and D-dimer levels in the observation group were higher than those in the control group,and the lymphocyte count and FEV1%pred were lower than those in the control group (all P<0.05).Age,D-dimer,BNP and FEV1%pred were independent influencing factors (all P<0.05).Based on the above influencing factors,a nomogram model was constructed.After ROC curve analysis,the area under the curve (AUC) of the nomogram model for predicting secondary PH in patients with AECOPD was 0.891 (95%CI:0.802~0.950，P<0.05),which had a good prediction efficiency.Conclusion:The independent risk factors for secondary PH in patients with AECOPD include age,D-dimer,BNP and FEV1%pred.The nomogram prediction model based on these four indicators has good predictive efficiency.

参考文献/References:

[1]ADHIKARI P,RANA R,PUNJA R,et al.Prevalence and impact of hyponatremia in chronic obstructive pulmonary disease.A systematic review and meta-analysis[J].Libyan J Med,2026,21(1):2642904.
[2]潘楚丽,宋尚道,余小锋.慢性阻塞性肺疾病患者并发轻度认知障碍的危险因素及肺康复训练对患者认知的改善作用[J].空军军医大学学报,2025,46(6):762-768,776.
[3]杨丽娜,张文爱,马雪梅,等.慢性阻塞性肺疾病急性加重期患者多重耐药菌感染病原学分布及与Th1/Th2细胞因子含量的关系[J].临床误诊误治,2026,39(1):30-37.
[4]LEE M C,WU C Y,CHEN S M,et al.Concurrent Chinese and Western medication use and risk of acute exacerbations in chronic obstructive pulmonary disease:A national cohort study[J].Integr Med Res,2026,15(2):101286.
[5]刘毅勇,刘丽霞,霍凤芝.胸部CT测量指标在AECOPD-PH诊断中的价值研究[J].中国CT和MRI杂志,2025,23(12):75-78.
[6]邓晔,李艳,王荣,等.硒蛋白P在慢性阻塞性肺疾病急性加重合并肺动脉高压患者血清中的表达和意义[J].临床内科杂志,2025,42(8):673-675.
[7]薛晓,张萌,肖瑶,等.运动负荷右心导管检查在肺血管疾病诊断与预后评估中的临床应用进展[J].中华结核和呼吸杂志,2025,48(10):965-969.
[8]王朴飞,熊丽焱,吕艳娇,等.超声心动图改良三尖瓣反流测速法估测肺动脉收缩压的准确性[J].临床超声医学杂志,2026,28(2):118-124.
[9]罗璐灵,刘富亿,王坤利,等.外周血NLR、RDW及Cys-C与AECOPD合并肺动脉高压的相关性[J].贵州医科大学学报,2025,50(6):897-902.
[10]魏士刚,闫春良,宿海峰,等.Cys-C和RDW在AECOPD及继发性肺动脉高压患者中的变化及其诊断价值[J].热带医学杂志,2023,23(6):815-818,822.
[11]中华医学会呼吸病学分会肺栓塞与肺血管病学组,中国医师协会呼吸医师分会肺栓塞与肺血管病工作委员会,全国肺栓塞与肺血管病防治协作组,等.中国肺动脉高压诊断与治疗指南（2021版）[J].中华医学杂志,2021,101(1):11-51.
[12]SINCLAIR D E,FRIAS J,VELO A,et al.Safety and efficacy of mepolizumab in eosinophilic chronic obstructive pulmonary disease:A systematic review and meta-analysis[J].Expert Rev Respir Med,2026,20(4):437-445.
[13]BOYCE L,PRYBUTOK V.Artificial intelligence for early detection and prediction of chronic obstructive pulmonary disease exacerbations[J].Healthcare (Basel),2026,14(6):806.
[14]王宇飞,刘琳,褚运松.NPPV对AECOPD合并重度Ⅱ型呼吸衰竭患者PaO2及pH值的影响分析[J].武警后勤学院学报(医学版),2021,30(2):12-15.
[15]涂友慧,胡先纬,尤青海.慢性阻塞性肺疾病急性加重期合并肺动脉高压的高危因素分析[J].临床肺科杂志,2023,28(12):1867-1871.
[16]张芝瑞,张艳,李俊杰,等.慢性阻塞性肺疾病并发肺动脉高压患者血清微小RNA-130a、中性粒细胞与淋巴细胞比值、胸部血管CT参数变化及其与病情程度关系研究[J].陕西医学杂志,2024,53(12):1640-1644.
[17]王培东.血府逐瘀汤治疗慢性阻塞性肺疾病急性加重期合并肺动脉高压的临床观察[J].陕西中医,2017,38(6):701-702.
[18]顾涛,尤雪梅,王娟,等.心脏彩超检查对慢性阻塞性肺疾病急性加重期并发肺动脉高压的评价及影响因素分析[J].中国急救复苏与灾害医学杂志,2024,19(12):1584-1587.
[19]栗慧,谢梅,闫金芳.血清ESM-1和MCP-1预测慢性阻塞性肺疾病急性加重期并发肺动脉高压的临床效能[J].临床误诊误治,2024,37(19):38-42.
[20]徐明艳,韩校鹏,刘英丽,等.慢性阻塞性肺疾病急性加重期并发肺动脉高压的危险因素[J].实用医学杂志,2022,38(19):2467-2471.
[21]李国慧,和嘉明,许振玲,等.高原地区慢性阻塞性肺疾病继发性肺动脉高压的危险因素研究[J].中国医刊,2023,58(1):46-49.
[22]高爱丽,丁媛,焦小净,等.体质指数降低和肺动脉压力升高及其交互作用对AECOPD患者预后的影响[J].实用心脑肺血管病杂志,2026,34(2):21-27.
[23]BOYCE L,PRYBUTOK V.Artificial Intelligence for early detection and prediction of chronic obstructive pulmonary disease exacerbations[J].Healthcare (Basel),2026,14(6):806.
[24]JOHNSTON K N,YOUNG M,KAY D,et al.Translating a home-based breathlessness service:A pilot study of feasibility,person-reported,and hospital use outcomes[J].J Clin Med,2025,14(11):3894.
[25]张娟.慢性阻塞性肺疾病急性加重患者进展至肺动脉高压的危险因素分析及预测模型构建[D].承德：承德医学院,2025.

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备注/Memo

备注/Memo:
国家自然科学基金青年科学基金资助项目（81902883）
更新日期/Last Update: 2026-09-15