应用主成分和聚类分析法探索慢性阻塞性肺疾病表型的临床研究

发布时间：2018-08-02 13:53

【摘要】：目的探索慢性阻塞性肺疾病(COPD)患者不同临床表型,为实现个体化诊治提供临床依据。方法对2011年10月—2012年3月南昌大学第二附属医院呼吸内科157例COPD患者,应用主成分分析(PCA)和聚类分析法识别不同COPD亚组分类。结果 122例研究对象参与分析,其中94例为男性患者;年龄为53~89岁,平均年龄为(72±7)岁。PCA分析出三个主要因子,在所有因子中累积方差贡献率约为73.1%。在PCA的基础上进行聚类分析将患者分成4类:(1)相对老年患者,吸烟指数高,中重度气流受限,重度呼吸困难,合并症少,炎症指标明显升高;(2)老年患者,中度气流受限,中度呼吸困难,吸烟指数低,合并症多,炎症指标明显升高;(3)与第2类比较,第3类为相对年轻患者,重度气流受限,重度呼吸困难,合并症少,吸烟指数低,炎症指标轻度升高;(4)与第1类比较,第4类患者吸烟指数低,合并症少,轻度呼吸困难,炎症指标升高不明显。结论气流受限程度相似的COPD患者可能有不一样的年龄、临床表现、合并症及预后,多维分析COPD患者,实行个体化管理,有助于提高患者治疗的效果。
[Abstract]:Objective to explore different clinical phenotypes of patients with chronic obstructive pulmonary disease (COPD) and to provide clinical basis for individualized diagnosis and treatment. Methods from October 2011 to March 2012, 157 patients with COPD in Department of Respiratory Medicine, second affiliated Hospital of Nanchang University, were divided into different COPD subgroups by principal component analysis (PCA) and cluster analysis. Results 122 subjects participated in the study, 94 of them were male, the age was 5389 years old, the average age was (72 卤7) years old. PCA analyzed three main factors, and the cumulative variance contribution rate of all factors was about 73.1%. Based on the cluster analysis of PCA, the patients were divided into four categories: (1) compared with the elderly patients, the smoking index was high, the severe airflow was limited, the severe dyspnea, the complication was less, the inflammation index was obviously increased, (2) the elderly patients, the moderate airflow limitation, Moderate dyspnea, low smoking index, more complications, and higher inflammation index. (3) compared with the second group, the third category is relatively young patients, with severe airflow limitation, severe dyspnea, less complications, and low smoking index. (4) compared with the first category, the smoking index of the patients in the fourth category was low, the complications were less, the inflammation index was not significantly increased, and the inflammation index was not significantly increased in the patients with mild dyspnea. Conclusion COPD patients with similar degree of airflow limitation may have different ages, clinical manifestations, complications and prognosis. Multidimensional analysis of patients with COPD and individualized management are helpful to improve the effect of treatment.
【作者单位】：南昌大学第二附属医院;
【分类号】：R563.9

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