血清HDAC2和SP-D对经鼻高流量氧疗治疗慢性阻塞性肺疾病急性加重期合并轻中度Ⅱ型呼吸衰竭患者预后的诊断价值  

Diagnostic value of serum HDAC2 and SP-D in the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease combined with mild to moderate type Ⅱ respiratory failure treated by nasal highflow oxygen therapy

作　　者：李江涛 王媛 王亮[1] 孟静[1] 李艳君[1] LI Jiangtao;WANG Yuan;WANG Liang;MENG Jing;LI Yanjun(Department of Respiratory and Critical Care Medicine,Hebei Chest Hospital,Hebei Province,Shijiazhuang 050000,China)

机构地区：[1]河北省胸科医院呼吸与危重症医学科,河北石家庄050000

出　　处：《中国医药导报》2022年第10期25-29,共5页China Medical Herald

基　　金：河北省医学科学研究重点课题计划项目(20200828)。

摘　　要：目的探讨血清组蛋白脱乙酰酶2(HDAC2)和肺表面活性物质蛋白D(SP-D)对经鼻高流量氧疗治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并轻中度Ⅱ型呼吸衰竭患者预后的诊断价值。方法选取2018年1月至2020年12月河北省胸科医院呼吸科收治的AECOPD合并轻中度Ⅱ型呼吸衰竭患者312例,所有患者均接受常规治疗及经鼻高流量氧疗,依据治疗14 d后的转归情况将其分为稳定组(224例)和加重组(88例)。收集患者一般资料及治疗前血清HDAC2、SP-D水平,分析经鼻高流量氧疗治疗AECOPD合并轻中度Ⅱ型呼吸衰竭患者预后的影响因素。采用受试者操作特征曲线及曲线下面积(AUC)分析治疗前血清HDAC2和SP-D水平对患者预后的诊断价值。结果加重组急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分、白细胞计数、中性粒细胞计数、C反应蛋白、红细胞沉降率、降钙素原、治疗前血清HDAC2、治疗前血清SP-D均高于稳定组,差异有统计学意义(P<0.05)。多因素分析结果显示,APACHEⅡ评分、治疗前血清HDAC2、治疗前血清SP-D水平为AECOPD合并轻中度Ⅱ型呼吸衰竭患者经鼻高流量氧疗14 d后预后的影响因素(P<0.05)。治疗前血清HDAC2、SP-D水平对AECOPD合并轻中度Ⅱ型呼吸衰竭患者经鼻高流量氧疗治疗14 d的预后具有一定的诊断价值(AUC>0.5,P<0.05)。结论血清HDAC2和SP-D水平与AECOPD合并轻中度Ⅱ型呼吸衰竭患者经鼻高流量氧疗治疗14 d的预后有一定的相关性,具有一定的诊断价值。Objective To investigate the diagnostic value of serum histone deacetylase 2(HDAC2)and pulmonary surfactant protein D(SP-D)in the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)combined with mild to moderate type Ⅱ respiratory failure treated by nasal high flow oxygen therapy.Methods A total of 312 patients with AECOPD complicated with mild to moderate type Ⅱ respiratory failure admitted to the Department of Respiratory,Hebei Chest Hospital from January 2018 to December 2020 were selected.All patients received conventional treatment and nasal high flow oxygen therapy,and they were divided into stable group(224 cases)and recombination group(88 cases)according to the outcome after 14 days of treatment.General data,serum HDAC2,and SP-D levels before treatment were collected and compared to analyze the prognostic factors of patients with AECOPD complicated with mild to moderate type Ⅱ respiratory failure treated with nasal high flow oxygen therapy.Receiver operating characteristic curve and area under curve(AUC)were used to analyze the diagnostic value of serum HDAC2 and SP-D levels before treatment for prognosis of patients.Results The acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score,white blood cell count,neutrophil count,C-reactive protein,erythrocyte sedimentation rate,procalcitonin,serum HDAC2 before treatment,and serum SP-D before treatment in the recombination group were higher than those in the stable group,and the differences were statistically significant(P<0.05).The results of multivariate analysis showed that APACHEⅡ score,serum HDAC2 before treatment,and serum SP-D level before treatment were the influencing factors of the prognosis of AECOPD with mild to moderate type Ⅱ respiratory failure after 14 days of nasal high flow oxygen therapy(P<0.05).Serum HDAC2 and SP-D levels before treatment had certain diagnostic value for the prognosis of AECOPD patients with mild to moderate type Ⅱ respiratory failure after 14 days of nasal hig

关 键 词：组蛋白脱乙酰酶2 肺表面活性物质蛋白D 经鼻高流量氧疗 慢性阻塞性肺疾病急性加重期 呼吸衰竭 预后 

分 类 号：R563[医药卫生—呼吸系统]