【摘要】 目的 分析胱抑素C（CysC）与慢性阻塞性肺疾病急性加重（AECOPD）合并肺动脉栓塞（PTE）的关系。方法 回顾性收集2022年12月至2023年12月在该院住院的149例肾功能正常的AECOPD患者临床资料及CysC等指标，依据CT肺动脉造影结果分为AECOPD组（98例）和合并组（AECOPD合并PTE,51例）。比较2组CysC、白细胞计数（WBC）、中性粒细胞计数（N）、中性粒细胞/淋巴细胞比值（NLR）、D-二聚体、超敏-C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、动脉血二氧化碳分压（PaCO₂）水平和pH值等指标，采用多因素logistic回归分析AECOPD合并PTE的高危因素，并利用受试者工作特征（ROC）曲线评估CysC在预测AECOPD合并PTE中的效能。结果 合并组CysC、WBC、N、NLR、D-二聚体、hs-CRP、IL-6水平及pH值高于AECOPD组，而PaCO₂水平低于AECOPD组，差异有统计学意义（P<0.05）。N、CysC水平升高是AECOPD合并PTE的高危因素（P<0.05）。CysC预测AECOPD合并PTE的曲线下面积（AUC）为0.715（95%CI 0.62～0.81,P<0.001）,最佳截断值为0.945 mg/L,灵敏度为66.7%,特异度为72.4%。结论 急性炎症反应及其严重程度在AECOPD合并PTE中发挥了重要作用，血清CysC对于预测AECOPD合并PTE具有一定的临床意义。更多还原

【Abstract】 Objective To analyze the relationship between cystatin C（CysC） and acute exacerbation of chronic obstructive pulmonary disease（AECOPD） combined with pulmonary embolism（PTE）.Methods A retrospective collection was conducted on clinical data and CysC indicators of 149 AECOPD patients with normal renal function admitted to the hospital from December 2022 to December 2023.Based on CT pulmonary angiography results, they were divided into AECOPD group（98 cases） and combined group（AECOPD combined with PTE,51 cases）.The indicators including CysC,white blood cell（WBC）,neutrophil count（N）,neutrophil/lymphocyte ratio（NLR）,D-dimer, high-sensitivity C-reactive protein（hs-CRP）,interleukin-6（IL-6）,arterial partial pressure of carbon dioxide（PaCO₂） levels, and pH between the two group were compared.Multivariate logistic regression was used to analyze the high-risk factors for AECOPD combined with PTE,and the receiver operating characteristic（ROC） curve was used to evaluate the efficacy of CysC in predicting AECOPD combined with PTE.Results The levels of CysC,WBC,N,NLR,D-dimer, hs-CRP,IL-6 and pH values in the merged group were higher than those in the AECOPD group, while the PaCO₂ level was lower than that in the AECOPD group, with statistical significance（P<0.05）.Elevated levels of N and CysC were high-risk factors for AECOPD combined with PTE.The area under the curve（AUC） predicted by CysC for AECOPD combined with PTE was 0.715（95%CI 0.62-0.81,P<0.001）,with an optimal cutoff value of 0.945 mg/L,sensitivity of 66.7%,and specificity of 72.4%.Conclusion Acute inflammatory response and its severity play an important role in AECOPD combined with PTE,and serum CysC has certain clinical significance in predicting AECOPD combined with PTE.更多还原