The value of red cell distribution width, procalcitonin, C-reactive protein, and mean platelet volume/platelet count in predicting the prognosis of patients with acute exacerbations of chronic obstructive pulmonary disease / 中国基层医药

ABSTRACT

Objective:To investigate the value of red cell distribution width (RDW), procalcitonin (PCT), C-reactive protein (CRP), mean platelet volume (MPV)/platelet count (PLT) in predicting the prognosis of patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD).Methods:The clinical data of 137 patients with AECOPD admitted to the Department of Laboratory Medicine of Haiyang People's Hospital from March 2020 to March 2021 were retrospectively analyzed. According to their prognosis, these patients were divided into the survival group ( n = 99) and the death group ( n = 38). RDW, MPV, and PLT were measured using a blood cell analyzer (mindray ABC5390) in all patients. PCT and CRP levels were measured using the ETHealthcare instrument in all patients. RDW, PCT, CRP, and MPV/PLT were compared between the two groups. The value of RDW, PCT, CRP and MPV/PLT in predicting the prognosis of patients with AECOPD was analyzed using receiver operating characteristic curves. Results:The length of hospital stay and hospitalization expenses in the survival group were (10.75 ± 2.51) days and (1.49 ± 0.46) ten thousand yuan, respectively, which were significantly shorter and lower than (12.81 ± 3.36) days and (2.18 ± 0.57) ten thousand yuan in the death group ( t = 6.11, 14.45, both P < 0.05). The level of PLT in the survival group was significantly higher than that in the death group [(214.01± 63.97) × 10 9/L vs. (189.04 ± 61.75) × 10 9/L, t = 2.07, P < 0.05]. RDW, PCT, CRP, MPV, and MPV/PLT in the survival group were (13.18 ± 2.30)%, (4.30 ± 1.82) ng/L, (31.06 ± 10.38) mg/L, (11.39 ± 2.16) fL, and (0.05 ± 0.01), respectively, which were significantly lower than (16.65 ± 1.78)%, (9.55 ± 2.11) ng/L, (68.21 ± 20.94) mg/L, (12.28 ± 2.09) fL, (0.06 ± 0.02) in the death group ( t = 8.38, 14.45, 13.82, 2.18, 3.88, all P < 0.05). The receiver operating characteristic curve analysis results showed that the area under the curves depicting the value of RDW, PCT, CRP, MPV/PLT and their combination in predicting AECOPD was 0.831, 0.978, 0.966, 0.713, 0.988, with the predictive sensitivity of 62.6%, 89.9%, 91.9%, 59.6%, 98.0%, respectively, and the predictive specificity of 97.4%, 97.4%, 100.0%, 65.8%, 92.1%, respectively. Conclusion:Combined detection of RDW, PCT, CRP and MPV/PLT has a high value for the prediction of AECOPD. Corresponding indicators should be selected according to the actual situation of patients to guide clinical diagnosis and treatment.