使用常规生物标志物超越乙氨基酸水平的综合性诺姆图:在AECOPD中提高皮质类固醇治疗结果的可预测性
Lin Feng1, Jiachen Li1, Zhenbei Qian2
1Department of Clinical Epidemiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China.
预测慢性阻塞性肺病 (AECOPD) 急性恶化的皮质类固醇治疗成功,可以通过将血中乙氨基酸细胞计数与其他临床因素结合起来来改善. 新的评分系统为预测AECOPD患者治疗结果提供了适度的增强.
科学领域:
- 肺部医学 肺部医学
- 临床生物标志物 临床生物标志物
- 预测建模预测建模
背景情况:
- 慢性阻塞性肺病 (AECOPD) 的急性恶化表现出对皮质类固醇治疗的不同反应.
- 预测治疗成功对于优化患者管理至关重要.
研究的目的:
- 评估是否将血中乙氨基酸水平与常规临床指标相结合,可以改善AECOPD中对皮质类固醇治疗结果的预测.
- 开发一个评分系统,用于预测AECOPD中的治疗失败.
主要方法:
- 对3254名AECOPD患者接受皮质类固醇治疗的回顾性分析.
- 利用LASSO和后勤回归来进行预测器选择,并开发了预测性名ograms.
- 使用AUC,校准图表,引导验证和决策曲线分析来评估nomogram性能.
主要成果:
- 在24.7%的患者中观察到治疗失败.
- 为吸烟者和非吸烟者开发了不同的名录,包括乙酸蛋白,血小板,CRP,LDL胆固醇,PNI,之前的AECOPD住院,缺血性心脏病和慢性肝病.
- 诺莫图表显示出适度的预测优越性,仅比单独的乙素水平 (AUC 0.644-0.647).
结论:
- 开发了使用易于使用的诺姆图,使用可访问的炎症,营养和免疫的生物标志物.
- 这些名谱在预测皮质类固醇治疗的AECOPD患者的治疗结果方面提供了适度的改善.
- 需要进一步研究新的生物标志物和额外的数据,以提高预测准确度.
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