目的 探讨慢性阻塞性肺疾病急性加重期（AECOPD）并发肺动脉高压（PH）的危险因素，寻 找潜在的预测指标。方法 回顾性分析郑州大学第二附属医院 2019 年 3 月至 2022 年 3 月收治住院符合 纳入标准的 AECOPD 患者 120 例，根据是否有 PH 将患者分为 AECOPD 组（n = 59）和 AECOPD 并发 PH 组 （n = 61）。通过多因素 logistic 回归分析探究 AECOPD 并发 PH 的影响因素，采用受试者特征工作曲线 （ROC 曲线）分析各指标对 AECOPD 并发 PH 的诊断价值。结果 AECOPD 并发 PH 组的 C 反应蛋白与白蛋 白比值（CAR）、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、C 反应蛋白（CRP）、白细胞介素⁃6（IL⁃6）、白蛋白、淋巴细胞计数、中性粒细胞计数、凝血酶原时间、D⁃二聚体和 N 端脑钠肽前体 （NT⁃proBNP）均高于 AECOPD 组（P < 0.05）；回归分析显示 CAR、NT⁃proBNP 和 D⁃二聚体是 AECOPD 并发 PH 的独立危险因素（P < 0.05）；ROC 曲线分析结果显示 CAR、NT⁃proBNP 和 D⁃二聚体的 AUC 为 0.854、 0.885 和 0.729。结论 CAR、NT⁃proBNP 和 D⁃二聚体较高的 AECOPD 患者并发 PH 的可能性越大。CAR 和 NT⁃proBNP 对AECOPD 并发PH 诊断价值优于D⁃二聚体。

Objective The of this study was to explore the risk factors of pulmonary hypertension（PH） in acute exacerbation of chronic obstructive pulmonary disease （AECOPD） and to find potential predictors. Methods A retrospective analysis was made of 120 AECOPD patients who admitted to The Second Affiliated Hospital of Zhengzhou University from March 2019 to March 2022. According to the status of PH，patients were divided into AECOPD group（n = 59）and AECOPD complicated with pH group（n = 61）. Multivariate logistic regression analysis was applied to explore the influencing factors of AECOPD complicated with PH. The receiver characteristic operating curve（ROC curve）was used to analyze the diagnostic value of each index for AECOPD complicated with PH. Results C⁃reactive protein to albumin ratio（CAR），neutrophil⁃to⁃lymphocyte ratio（NLR）， platelet⁃to⁃lymphocyte ratio（PLR），C⁃reactive protein（CRP），interleukin⁃6（IL⁃6），albumin，lymphocyte count， neutrophil count，prothrombin time，D ⁃ dimer and N ⁃terminal pro ⁃ brain natriuretic peptide（NT ⁃ proBNP）were higher than those in AECOPD group（P < 0.05）. Regression analysis showed that CAR，NT⁃proBNP and D⁃dimer were independent risk factors for AECOPD complicated with PH（P < 0.05）. The results of ROC curve analysis showed that the AUCs of CAR，NT⁃proBNP and D⁃dimer were 0.854，0.885 and 0.729. Conclusions AECOPD patients with higher CAR，NT ⁃proBNP and D ⁃dimer were more likely to develop PH. CAR and NT ⁃proBNP are better than D⁃dimer in the diagnosis of AECOPD complicated with PH.