Analysis Of Clinical Features And Risk Factors Of Patients With Idiopathic Pulmonary Interstitial Fibrosis With Malnutrition

Objective:The prognosis of patients with idiopathic pulmonary interstitial fibrosis complicated with malnutrition is often poor.Early detection and prevention of development are the main treatment methods at present.By investigating the nutritional status of IPF patients,this study will analyze the clinical characteristics and related influencing factors of IPF patients complicated with malnutrition,with a view to providing certain guiding value for the prevention,diagnosis and treatment of IPF patients complicated with malnutrition.Methods:The clinical data of IPF patients admitted to the First Hospital of Lanzhou University from July 2020 to July 2022 were collected.The clinical data of180 patients with IPF were collected according to the selection criteria as the research objects.The subjects were divided into malnutrition group（group A）,malnutrition risk group（group B）and well-nourished group（group C）according to the NA-SF score.SPSS 26.0 software was used to conduct a retrospective study and analysis of the clinical data of the three groups of patients.Results:1.General situation:There were significant differences in age,BMI and the number of acute exacerbations in the past year in the malnutrition group,the malnutrition risk group and the well-nourished group of IPF patients（P<0.05）,but no significant differences in gender,length of hospital stay,smoking history,combined hypertension or diabetes（P>0.05）.2.Serological examination:There were significant differences in HB,HCT,MCHC,NEUT%,NEUT,NLR,PLR,PDW,CRP,SIINI,ALB,A/G,CHE,Na⁺,Cl^-,Ca²⁺,TC,TG,LDL and Apo B among the three groups of IPF patients（P<0.05）.There were no significant differences in WBC,RBC,PLT,MCV,MCH,LY,MONO,MPV,CV,SD,TP,ALB,ALP,GGT,UA,Crea,Urea,K⁺,P,Mg²⁺,HDL,LPA,Apo A,LDH,HCY（P>0.05）.3.Imaging findings:Among the 180 patients included in this study,mesh shadows（118 cases）were the most common according to chest HRCT results,among which ground-glass shadows,pleural thickening and emphysema showed statistically significant differences among the three groups（P<0.05）,while other imaging findings showed no statistically significant differences among the three groups.4.A univariate analysis of all potential influencing factors for malnutrition in IPF patients was performed.It was found that age,BMI,the number of acute exacerbations in recent one year,SIINI,HB,NEUT%,NEUT,NLR,PLR,ALB,A/G,GGT,CHE,Urea,Crea,Na⁺,Cl^-,Ca²⁺,TC,TG,Apo B and DLCO had statistical differences（P<0.05）.Logistic multivariate regression analysis was carried out based on the meaningful indicators of univariate analysis,and it was found that BMI,SIINI,NEUT%,NEUT and PLR were independent influencing factors of malnutrition in IPF patients,among which SIINI,NEUT%,NEUT and PLR were independent risk factors of malnutrition in IPF patients.5.Spearman correlation analysis was conducted on DLCO level and related indexes of malnutrition in patients with IPF combined with malnutrition.DLCO in patients with IPF combined with malnutrition was positively correlated with ALB,Na+and Ca²⁺（P<0.05）,and SIINI was negatively correlated with DLCO.6.Combined SIINI,ALB,Na⁺,Ca²⁺and four indexes with DLCO,ROC curve analysis was performed,and the results showed:The AUC of SIINI was 0.781,that of ALB was 0.693,that of Na⁺was 0.682,that of Ca²⁺was 0.599,and that of the combination of the four was 0.801,which had the highest diagnostic value for the decrease of DLCO in patients with IPF combined with malnutrition.Conclusion:1.SIINI is an independent risk factor for malnutrition in IPF patients,and the larger the SIINI,the more likely the patient is to suffer from malnutrition.2.Patients with IPF combined with malnutrition had worse pulmonary dispersion function and higher rate of acute exacerbation than those with normal nutrition.3.SIINI was negatively correlated with lung dispersion function in patients with IPF combined with malnutrition,while ALB,Na⁺and Ca²⁺were positively correlated with lung dispersion function.SIINI,ALB,Na⁺and Ca²⁺could be used as indicators to predict the deterioration of lung function in patients with IPF combined with malnutrition,and the combined detection ability of the four indicators was stronger than that of a single indicator.