老年COPD合并肺部感染患者血清ANXA1、sCD14、HPT水平变化及对预后的预测价值  

Changes of serum ANXA1,sCD14 and HPT levels in elderly patients with COPD complicated with pulmonary infection and their prognostic value

作　　者：白碧慧 陈余思[1] 宋本艳 张榆铃 王利玲[1] 李明凤 孙兰 Bai Bihui;Chen Yusi;Song Benyan;Zhang Yuling;Wang Liling;Li Mingfeng;Sun Lan(Department of Respiratory and Critical Medicine,Panzhihua Integrated Traditional Chinese and Western Medicine Hospital, Sichuan Province,Panzhihua 617000,China)

机构地区：[1]四川省攀枝花市中西医结合医院呼吸与危重医学科,617000

出　　处：《疑难病杂志》2021年第12期1192-1196,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：四川省科技计划项目(2018JDR2291)。

摘　　要：目的分析老年慢性阻塞性肺疾病(COPD)合并肺部感染患者血清膜联蛋白A1(ANXA1)、可溶性白细胞分化抗原14(sCD14)、触珠蛋白(HPT)水平变化及对预后的预测价值。方法选取2019年1月-2020年10月四川省攀枝花市中西医结合医院呼吸与危重医学科诊治老年COPD合并肺部感染患者120例,根据患者预后分为生存组(n=105)与死亡组(n=15),检测并比较2组血清ANXA1、sCD14、HPT水平,评价各指标对预后的预测价值。结果死亡组患者血清ANXA1、sCD14、HPT水平高于生存组(t/P=6.231/<0.001、4.555/<0.001、5.402/<0.001);随着COPD分级升高患者血清ANXA1、sCD14、HPT水平逐渐升高,差异有统计学意义(F/P=27.860/<0.001、20.307/<0.001、17.538/<0.001);血清ANXA1、sCD14、HPT水平与COPD分级呈正相关(r/P=0.578/<0.001、0.606/<0.001、0.559/<0.001),与肺功能指标第一秒用力呼气量占预计值百分比(FEV_(1)%pred)、第一秒用力呼气量/用力肺活量(FEV_(1)/FVC)呈负相关(ANXA1:r/P=-0.612/<0.001、-0.657/<0.001;sCD14:r/P=-0.591/<0.001、-0.628/<0.001;HPT:r/P=-0.637/<0.001、-0.583/<0.001);血清ANXA1、sCD14、HPT水平升高是老年COPD合并肺部感染死亡的危险因素[HR(95%CI)=6.375(2.415~16.829)、4.757(1.834~12.338)、5.640(3.117~10.204)];血清ANXA1、sCD14、HPT三者联合预测预后的AUC为0.874,优于各指标(0.785、0.673、0.737)单独预测价值(Z/P=3.486/0.001、2.009/0.045、3.723/<0.001)。结论老年COPD合并肺部感染患者血清ANXA1、sCD14、HPT水平升高,且与COPD分级、肺功能相关,血清ANXA1、sCD14、HPT联合检测对老年COPD合并肺部感染预后具有良好预测价值。Objective To analyze the changes of serum Annexin A1(ANXA1),soluble leukocyte differentiation antigen 14(sCD14)and haptoglobin(HPT)in elderly patients with chronic obstructive pulmonary disease(COPD)complicated with pulmonary infection and their prognostic value.Methods One hundred and twenty elderly patients with COPD complicated with pulmonary infection diagnosed and treated by the Department of Respiratory and Critical Medicine of Panzhihua Integrated Traditional Chinese and Western Medicine Hospital from January 2019 to October 2020 were divided into survival group(n=105)and death group(n=15)according to the prognosis.The levels of serum ANXA1,sCD14 and HPT in the two groups were detected and compared to evaluate the predictive value of each index on the prognosis.Results The levels of serum ANXA1,sCD14 and HPT in the death group were significantly higher than those in the survival group(t/P=6.231/<0.001,4.555/<0.001,5.402/<0.001).With the increase of COPD grade,the levels of serum ANXA1,sCD14 and HPT increased gradually,and the difference was statistically significant(F/P=27.860/<0.001,20.307/<0.001,17.538/<0.001).The levels of serum ANXA1,sCD14 and HPT were all positively correlated with the grade of COPD(r/P=0.578/<0.001,0.606/<0.001,0.559/<0.001),and negatively correlated with the percentage of forced expiratory volume in the first second(FEV_(1)%PRED)and forced expiratory volume in the first second/forced vital capacity(FEV_(1)/FVC)(ANXA1:r/P=-0.612/<0.001,-0.657/<0.001;sCD14:r/P=-0.591/<0.001,-0.628/<0.001;HPT:r/P=-0.637/<0.001,-0.583/<0.001).The elevated levels of serum ANXA1,sCD14 and HPT are the risk factors for death of elderly COPD complicated with pulmonary infection[HR(95%CI)=6.375(2.415-16.829),4.757(1.834-12.338),5.640(3.117-10.204)].The AUC of serum ANXA1,sCD14 and HPT in predicting prognosis was 0.874,which was better than that of each index(0.785,0.673,0.737)(Z/P=3.486/0.001,2.009/0.045,3.723/<0.001).Conclusion The levels of serum ANXA1,sCD14 and HPT in elderly COPD patients with pulmonary i

关 键 词：慢性阻塞性肺疾病 肺部感染 膜联蛋白A1 可溶性白细胞分化抗原14 触珠蛋白 预后 老年人 

分 类 号：R563.9[医药卫生—呼吸系统]