布地奈德福莫特罗联合吡非尼酮胶囊治疗COPD合并肺间质纤维化的临床疗效及构建并验证列线图模型<sup>*</sup>

doi:10.3969/j.issn.1671-7171.2024.05.006

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摘要【目的】探讨布地奈德福莫特罗联合吡非尼酮胶囊治疗慢性阻塞性肺病(COPD)合并肺间质纤维化的疗效及构建并验证临床疗效的列线图模型。【方法】选取2019年9月至2023年12月在本院接受布地奈德福莫特罗联合吡非尼酮胶囊治疗的107例COPD合并肺间质纤维化患者,根据治疗效果分为改善组(治疗后显效＋有效)和无效组(治疗后无效),对两组患者临床资料及实验室数据进行单因素分析,并将有统计学意义的因素进行多因素回归分析,绘制列线图以确定治疗效果的影响因素。【结果】107例患者中,改善组83例(77.57%),无效组24例(22.43%)。两组年龄、性别、体重指数(BMI)、酗酒史、糖尿病史、高血压史、心率、白细胞计数、动脉血氧分压(PaO₂)、动脉血二氧化碳分压(PaCO₂)、乳酸、C反应蛋白(CRP)比较,差异无统计学差异(P>0.05);改善组吸烟史占比、肺功能分级、COPD病程、APACHEⅡ评分、N-末端B型钠利尿肽前体(NT-proBNP)水平与无效组比较,差异有统计学意义(P<0.05)。多因素回归分析显示:有吸烟史、肺功能分级Ⅲ～Ⅳ级、COPD病程长、APACHEⅡ评分高、NT-proBNP水平高是COPD合并肺间质纤维化患者治疗无效的独立危险因素(P<0.05),构建列线图显示有较好的预测效能。【结论】吸烟史、肺功能分级Ⅲ～Ⅳ级、COPD病程长、APACHEⅡ评分高、NT-proBNP水平高是影响布地奈德福莫特罗联合吡非尼酮胶囊治疗COPD合并肺间质纤维化患者无效的危险因素,可作为COPD合并肺间质纤维化患者疗效的预测工具,为临床治疗提供参考。

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	尚艳

关键词 ：肺疾病,慢性阻塞性, 肺纤维化, 布地奈德,富马酸福莫特罗复方合剂, 吡啶酮类

Abstract：【Objective】To explore the efficacy of budesonide-formoterol combined with pirfenidone capsules in treating Chronic Obstructive Pulmonary Disease (COPD) with pulmonary interstitial fibrosis, and at constructing and validating a nomogram model for predicting clinical efficacy.【Methods】From September 2019 to December 2023, 107 patients with COPD combined with pulmonary interstitial fibrosis, who were treated with budesonide-formoterol combined with pirfenidone capsules in the Department of Respiratory and Critical Care Medicine at the First Affiliated Hospital of Henan University, were selected. Based on treatment outcomes, they were divided into an improvement group (markedly effective+effective) and an ineffective group (ineffective). Clinical data and laboratory results of both groups were analyzed through univariate analysis, and factors of statistical significance were subjected to multivariate regression analysis to construct a nomogram for identifying factors influencing treatment outcomes.【Results】Out of the 107 patients included, 83 were in the improvement group (77.57%) and 24 in the ineffective group (22.43%). There were no statistically significant differences between the two groups in terms of age, gender, BMI, history of alcohol abuse, diabetes, hypertension, heart rate, white blood cell count, PaO₂, PaCO₂, lactate, and CRP (P>0.05). Significant differences were found between the improvement and ineffective groups regarding smoking history, pulmonary function classification, COPD duration, APACHEⅡscore, and NT-proBNP (P<0.05). Multivariate regression analysis revealed that a history of smoking, pulmonary function classification of Ⅲ-Ⅳ,long duration of COPD, high APACHEⅡ score, and high NT-proBNP were independent risk factors for ineffective treatment in patients with COPD combined with pulmonary interstitial fibrosis (P<0.05). A nomogram was constructed, demonstrating good predictive performance.【Conclusion】The risk factors affecting the efficacy of budesonide-formoterol combined with pirfenidone capsules in treating patients with COPD combined with pulmonary interstitial fibrosis were identified as a history of smoking, pulmonary function classification of Ⅲ-Ⅳ, long duration of COPD, high APACHEⅡ score, and high NT-proBNP. These can serve as predictive tools for the efficacy in patients with COPD combined with pulmonary interstitial fibrosis, providing a reference for clinical treatment decision-making.

Key words： Pulmonary Disease, Chronic Obstructive Pulmonary Fibrosis Budesonide, Formoterol Fumarate Drug Combination Pyridones

收稿日期: 2024-03-15

中图分类号:

R563

基金资助:*河南省科学技术厅项目(编号:182102310238)

引用本文:

尚艳. 布地奈德福莫特罗联合吡非尼酮胶囊治疗COPD合并肺间质纤维化的临床疗效及构建并验证列线图模型^*[J]. 医学临床研究, 2024, 41(5): 661-665.
SHANG Yan. Construction and Validation of a Nomogram Model for the Clinical Efficacy of Budesonide-Formoterol Combined with Pirfenidone Capsules in the Treatment of COPD with Pulmonary Interstitial Fibrosis. JOURNAL OF CLINICAL RESEARCH, 2024, 41(5): 661-665.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2024.05.006 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2024/V41/I5/661

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