Introduction. Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) contributes to a poor prognosis. Reliable biomarkers to predict adverse outcomes during hospitalization are important. Aim. To investigate the relationship between the serum cholinesterase (ChE) level and adverse clinical outcomes, including hypoxemia severity, hypercapnia, duration of hospital stay (DoHS), and noninvasive ventilation (NIV) requirement, in patients with AECOPD. Methods. Patients hospitalized with AECOPD in the Wuhu Hospital of Traditional Chinese Medicine between January 2017 and December 2021 were included. Results. A total of 429 patients were enrolled. The serum ChE level was significantly lower in patients with hypercapnia, who required NIV during hospitalization and who had a DoHS of >10 days, with an oxygenation index < 300. The ChE level was correlated negatively with the C-reactive protein level and neutrophil-to-lymphocyte ratio and correlated positively with the serum albumin level. Multivariate logistic regression analysis indicated that a serum ChE level of ≤4116 U/L (OR = 2.857, 95% CI = 1.46–5.58, ) was associated significantly with NIV requirement. Conclusions. The serum ChE level was correlated significantly with complicating severe hypoxemia, hypercapnia, prolonged DoHS, and the need for NIV in patients hospitalized with AECOPD. The serum ChE level is a clinically important risk-stratification biomarker in patients hospitalized with AECOPD.

中文翻译：

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使用血清胆碱酯酶水平作为慢性阻塞性肺疾病急性加重住院患者非致命临床结果的预后标志物

介绍。慢性阻塞性肺疾病（AECOPD）急性加重导致预后不良。预测住院期间不良后果的可靠生物标志物非常重要。目的。探讨 AECOPD 患者血清胆碱酯酶 (ChE) 水平与不良临床结局之间的关系，包括低氧血症严重程度、高碳酸血症、住院时间 (DoHS) 和无创通气 (NIV) 需求。方法。纳入2017年1月至2021年12月在芜湖市中医院住院的AECOPD患者。结果。共有 429 名患者入组。高碳酸血症患者、住院期间需要 NIV、DoHS > 10 天、氧合指数 < 300 的患者血清 ChE 水平显着较低。ChE 水平与 C 反应蛋白水平和中性粒细胞水平呈负相关。与淋巴细胞的比率与血清白蛋白水平呈正相关。多变量logistic回归分析表明血清ChE水平≤4116 U/L（OR = 2.857，95% CI = 1.46–5.58，）与 NIV 需求显着相关。结论。AECOPD 住院患者的血清 ChE 水平与严重低氧血症、高碳酸血症、DoHS 延长以及 NIV 需求显着相关。血清 ChE 水平是 AECOPD 住院患者临床上重要的风险分层生物标志物。