非对称二甲基精氨酸与对称二甲基精氨酸对稳定期慢性阻塞性肺疾病患者预后的预测价值  

Predictive value of asymmetric dimethylarginine and symmetric dimethylarginine on prognosis of patients with stable chronic obstructive pulmonary disease

作　　者：黎伟[1] 罗麟洁 张友兰[1] 刘霞[1] 唐凤鸣[1] LI Wei;LUO Lin-jie;ZHANG You-lan;LIU Xia;TANG Feng-ming(Department of Respiratory and Critical Care Medicine,Wenjiang District People′s Hospital of Chengdu,Chengdu 611130,Sichuan,China)

机构地区：[1]成都市温江区人民医院呼吸与危重症医学科,四川省成都市611130

出　　处：《广西医学》2022年第21期2465-2468,2474,共5页Guangxi Medical Journal

基　　金：四川省卫生健康科研课题普及项目(19PJ183)。

摘　　要：目的探讨非对称二甲基精氨酸(ADMA)与对称二甲基精氨酸(SDMA)对稳定期慢性阻塞性肺疾病(COPD)患者近期及远期预后的预测价值。方法选取230例稳定期COPD患者作为研究对象。根据圣乔治呼吸问卷的中位得分将患者分为控制良好组和控制不良组,各115例。比较两组患者一般资料、血肌酐水平、血清ADMA及SDMA水平。分析一般资料、血肌酐水平、血清ADMA及SDMA水平与稳定期COPD患者死亡及出院后1年内急性加重的相关性。采用受试者工作特征(ROC)曲线分析血清ADMA及SDMA水平单独及联合预测COPD患者近期及远期预后的价值。结果截至随访终点,230例稳定期COPD患者中有25例患者死亡,152例患者在出院后1年内出现急性加重。与控制良好组相比,控制不良组患者年龄更大、血清ADMA及SDMA水平更高(均P<0.05)。吸烟、合并卒中、合并糖尿病,以及血肌酐、血清ADMA及SDMA水平与COPD患者发生死亡呈正相关,血清ADMA及SDMA水平与患者出院后1年内急性加重呈正相关(均P<0.05)。ROC曲线分析结果显示,血清ADMA及SDMA水平均对COPD患者死亡具有较高预测价值(曲线下面积均大于0.8),且联合检测对COPD患者死亡的预测效能高于单独检测;血清ADMA及SDMA水平对COPD患者出院后1年内急性加重具有较高预测价值(曲线下面积均大于0.7),且联合检测预测效能高于单独检测。结论稳定期COPD患者血清ADMA及SDMA水平升高,与患者发生死亡和出院后1年内急性加重均相关,两者联合预测患者发生死亡和出院后1年内急性加重的效能较高。Objective To investigate the predictive value of asymmetric dimethylarginine(ADMA)and symmetric dimethylarginine(SDMA)on short-term and long-term prognosis of patients with stable chronic obstructive pulmonary disease(COPD).Methods A total of 230 patients with stable COPD were selected as the research subjects.According to the median score of the St George′s Respiratory Questionnaire,the patients were divided into well-controlled group oRpoorly controlled group,with 115 cases in each group.The general data,and levels of serum creatinine,serum ADMA and serum SDMA were compared between the two groups.The correlation of general data,serum creatinine level,and serum ADMA and SDMA levels with death and acute exacerbation within 1 yeaRafteRdischarge in patients with stable COPD was analyzed.The receiveRoperating characteristic(ROC)curve was used to analyze the value of serum ADMA and SDMA levels alone and jointly foRpredicting the short-term and long-term prognosis in COPD patients.Results By the end of follow-up,25 of 230 patients with stable COPD died,and 152 of 230 patients suffered from acute exacerbation within 1 yeaRafteRdischarge.Compared with the well-controlled group,the age of patients was older,and the levels of serum ADMA and SDMA were higheRin the poorly controlled group(all P<0.05).Smoking,concomitant stroke and diabetes mellitus,as well as serum creatinine,serum ADMA and SDMA levels positively correlated with the occurrence of death in patients with COPD,and serum ADMA and SDMA levels positively correlated with acute exacerbation of patients within 1 yeaRafteRdischarge(all P<0.05).The results of ROC curve analysis revealed that serum ADMA and SDMA levels presented a relatively high predictive value on death of patients with COPD(the area undeRthe curve was largeRthan 0.8),and the predictive efficiency of combined detection on death in patients with COPD was higheRthan that of single detection.Serum ADMA and SDMA levels exhibited a relatively high predictive value on acute exacerbation of COPD patients

关 键 词：稳定期慢性阻塞性肺疾病 非对称二甲基精氨酸 对称二甲基精氨酸 预后 预测价值 

分 类 号：R563.9[医药卫生—呼吸系统]