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【目的】 观察慢性阻塞性肺疾病急性加重期（AECOPD）患者治疗前后气道内炎性介质与抗炎介质水平变化，阐明COPD气道局部炎症与气流受限的关系。【方法】 检测48例COPD急性加重期患者入院时（A1组）及治疗1周后（A2组）诱导痰肿瘤坏死因子γ（TNF-γ）和可溶性肿瘤坏死因子受体55、75（sTNF-R55、sTNF-R75）的水平并进行肺功能测定。以28例健康志愿者（吸烟者，B1组；不吸烟者，B2组）为对照组进行分析治疗前后炎症因子及肺功能变化。【结果】 AECOPD治疗前后诱导痰中TNF-γ和sTNF-R55、sTNFR75的水平均高于健康组（P

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Copyright of Fudan University Journal of Medical Sciences is the property of Fudan University Journal of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Electric Machines & Control / Dianji Yu Kongzhi Xuebao is the property of Electric Machines & Control and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

构建用于预测慢性阻塞性肺疾病急性加重期（AECOPD）患者死亡风险的新模型，并验证其应用效 能。方法 对757例AECOPD患者临床资料进行回顾性分析。以住院期间死亡为结局事件，比较死亡与存活AE‑ COPD患者临床资料。采用Logistic回归单因素分析初步筛选出用于构建AECOPD死亡风险预测模型的变量；对初 步选取的变量做Logistic回归多因素分析得到危险预测因子及各自的β值，根据β值确定AECOPD患者住院期间病 死风险的预测模型包含的各变量的分值权重。应用受试者工作特征曲线（ROC）和曲线下面积（AUC）对建立的 AECOPD患者住院期病死风险预测模型的预测性能进行评价。结果 与存活组比较，死亡组年龄、中性粒细胞数、 C反应蛋白、尿素、肌酐均高（P均<0.05），收缩压和白蛋白低（P均<0.05）。年龄、意识、脉率、中性粒细胞数、 C反应 蛋白、尿素、肌酐、白蛋白及之前住院次数与AECOPD患者住院病死率有关（P均<0.05）；年龄、脉率、尿素、白蛋白、 之前住院次数为AECOPD患者住院病死率的独立危险预测因子。基于这个结果构建了APN评分和APUAN评分2 个模型用于预测AECOPD患者住院病死率。APN评分包含年龄、脉率、之前住院次数3个变量，总分为0～7分，分 值越高表示患者预后越差。APUAN评分包含年龄、脉率、尿素、白蛋白、之前住院次数5项指标，总分为0～10分，分 值越高表示预后越差。APN评分预测AECOPD患者住院病死率的AUC为0.813（95%CI ： 0.722， 0.904），最佳切点 为4.5，此时灵敏性为0.714、特异性为0.801、Youden指数为0.515、阳性预测值为0.099、阴性预测值为0.988、阳性 拟然比为3.588、阴性拟然比为0.357；APUAN评分预测AECOPD患者住院病死率的AUC为0.856（95%CI： 0.769， 0.943），最佳切点为5.5，此时灵敏性为0.714、特异性为0.859、Youden指数为0.573、阳性预测值为0.133、阴性预 测值为0.990、阳性拟然比为5.064、阴性拟然比为0.333。APN评分与传统的CURB65评分AUC相比， P＝0.2746； APUAN评分与CURB65评分AUC相比较， P=0.0159。结论 APN评分预测AECOPD患者住院病死率的准确性与 CURB65评分相似，但它更加简单、快捷、方便、无创；APUAN评分比CURB65评分有更好的预测能力，但需通过有创 手段获得尿素和白蛋白值。 [ABSTRACT FROM AUTHOR]

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Copyright of Journal of Modern Medicine & Health is the property of Journal of Modern Medicine & Health and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)