关键词: 肺疾病, 慢性阻塞性, 急性加重期, 症状群, 前哨症状, 炎症, 护理

Abstract:

Objective To explore the current status of symptom clusters and sentinel symptoms in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD），to analyze the correlation between the severity of sentinel symptoms and inflammatory indexes，and to provide a basis for symptom cluster interventions. Methods From October 2021 to March 2022，165 patients with AECOPD hospitalized in the Department of Respiratory and Critical Care Medicine of a tertiary care hospital in Nanning were conveniently selected. The questionnaires were administered using a revised version of the Memory Symptom Assessment Scale，and the results of inflammatory indexes were collected from the patients’ first tests after admission. Principal component analysis was used to extract symptom clusters，and the results of association analysis based on the Apriori algorithm were used to determine the sentinel symptoms within symptom clusters，and correlation analysis was used to explore the relationship between patients’ sentinel symptoms and inflammatory indexes. Results 3 symptom clusters existed in AECOPD patients，including respiratory symptom cluster，affective symptom cluster，and fatigue symptom cluster. Correlation analysis by the Apriori algorithm showed that lack of energy was the sentinel symptom of respiratory symptom cluster，feeling sad was the sentinel symptom of affective symptom cluster，and inattention was the sentinel symptom of fatigue symptom cluster. Correlation analysis showed that neutrophil-to-lymphocyte ratio and calcitoninogen were positively correlated with the severity of energy deficiency（r=0.179，P<0.05；r=0.246，P<0.01），and prealbumin was negatively correlated with it（r=-0.167，P<0.05）；monocyte count was positively correlated with the severity of feeling sad（r=0.236，P<0.01）；eosinophil count was negatively correlated with the severity of inattentiveness（r=-0.197，P<0.05）. Conclusion Sentinel symptoms exist within the symptom cluster of AECOPD patients，and their severity correlates with inflammatory indicators neutrophil-to-lymphocyte ratio，calcitoninogen，prealbumin，monocyte count，and eosinophil count. It is recommended that healthcare professionals can use sentinel symptoms as an entry point for symptom cluster management and develop individualized interventions for patients.

Key words: Pulmonary Disease, Chronic Obstructive, Acute Exacerbation, Symptom Clusters, Sentinel Symptoms, Inflammation, Nursing Care