血清Hcy、β_(2)-MG、Copeptin及CAT、APACHEⅡ评分与老年COPD伴呼吸衰竭患者预后的相关性  

Correlation of serum Hcy,β_(2)-MG,Copeptin,CAT socre,APACHEⅡscore and prognosis in elderly COPD patients with respiratory failure

作　　者：王丹 何达 续华利 WANG Dan;HE Da;XU Huali(Department of Respiratory and Critical Care,Jingbian County People′s Hospital,Yulin,Shaanxi 718500,China;Department of Respiratory and Critical Care,Yulin First Affiliated Hospital,Yulin,Shaanxi 719000,China)

机构地区：[1]陕西省靖边县人民医院呼吸与危重科,陕西榆林718500 [2]陕西省榆林市第一附属医院呼吸与危重科,陕西榆林719000

出　　处：《检验医学与临床》2023年第15期2210-2213,2217,共5页Laboratory Medicine and Clinic

摘　　要：目的 探讨血清同型半胱氨酸(Hcy)、β_(2)-微球蛋白(β_(2)-MG)、和肽素(Copeptin)及慢性阻塞性肺病评估测试(CAT)、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分与老年慢性阻塞性肺疾病(COPD)伴呼吸衰竭患者预后的相关性。方法 回顾性分析2019年5月至2022年9月在靖边县人民医院就诊的176例老年COPD伴呼吸衰竭患者的临床资料,根据患者的预后情况分为预后不良组(n=60)和预后良好组(n=116)。比较两组患者的临床资料,检测血清Hcy、β_(2)-MG、Copeptin水平,评估CAT评分、APACHEⅡ评分;绘制受试者工作特征(ROC)曲线分析血清Hcy、β_(2)-MG、Copeptin水平及CAT、APACHEⅡ评分预测老年COPD伴呼吸衰竭患者预后不良的价值;通过多因素Logistic回归分析老年COPD伴呼吸衰竭患者预后不良的危险因素。结果 预后不良组血清Hcy、β_(2)-MG、Copeptin水平及CAT、APACHEⅡ评分显著高于预后良好组(P<0.05);ROC曲线结果显示,血清Hcy、β_(2)-MG、Copeptin水平及CAT、APACHEⅡ评分预测老年COPD伴呼吸衰竭患者预后不良的曲线下面积分别为0.860、0.757、0.835、0.773、0.766,灵敏度分别为0.767、0.733、0.800、0.700、0.733,特异度分别为0.862、0.724、0.759、0.793、0.776;多因素Logistic回归分析显示,Hcy≥16.760μmol/L、β_(2)-MG≥2.870 mg/L、Copeptin≥25.755 pmol/L、CAT评分≥23.905分、APACHEⅡ评分≥29.059分是老年COPD伴呼吸衰竭患者预后不良的危险因素(P<0.05)。结论 血清Hcy、β_(2)-MG、Copeptin及CAT、APACHEⅡ评分与老年COPD伴呼吸衰竭患者预后显著相关。Objective To investigate the correlation between serum homocysteine(Hcy),β_(2)-microglobulin(β_(2)-MG),Copeptin,Chronic Obstructive Pulmonary Disease Assessment Test(CAT)socre,Acute Physiology and Chronic Health Status Score SystemⅡ(APACHEⅡ)score and prognosis of elderly patients with chronic obstructive pulmonary disease(COPD)and respiratory failure.Methods Clinical data of 176 elderly COPD patients with respiratory failure admitted to Jingbian County People′s Hospital from May 2019 to September 2022 were retrospectively analyzed and divided into poor prognosis group(60 cases)and good prognosis group(116 cases)according to their prognosis.Clinical data of the two groups were compared,serum Hcy,β_(2)-MG and Copeptin levels were detected,and CAT score and APACHEⅡscore were evaluated.The value of serum Hcy,β_(2)-MG,Copeptin,CAT and APACHEⅡscores in predicting poor prognosis of elderly COPD patients with respiratory failure was analyzed by receiver operating characteristic(ROC)curve.Multivariate Logistic regression analysis was used to identify the risk factors of poor prognosis in elderly COPD patients with respiratory failure.Results Serum levels of HCY,β_(2)-MG and Copeptin,and scores of CAT and APACHEⅡin the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05).The results of ROC curve showed that the areas under the curve of serum Hcy,β_(2)-MG,Copeptin and CAT and APACHEⅡscores in predicting poor prognosis of elderly COPD patients with respiratory failure were 0.860,0.757,0.835,0.773,0.766,the sensitivity were 0.767,0.733,0.800,0.700,0.733,and the specificity were 0.862,0.724,0.759,0.793,0.776,respectively.The multivariate Logistic regression analysis showed that Hcy≥16.760μmol/L,β_(2)-MG≥2.870 mg/L,Copeptin≥25.755 pmol/L,CAT score≥23.905,APACHEⅡscore≥29.059 were risk factors for poor prognosis in elderly COPD patients with respiratory failure(P<0.05).Conclusion Serum Hcy,β_(2)-MG,Copeptin,CAT and APACHEⅡscores were significantly corre

关 键 词：同型半胱氨酸 β_(2)-微球蛋白 和肽素 慢性阻塞性肺病评估测试 急性生理学与慢性健康状况评分系统Ⅱ 慢性阻塞性肺疾病 

分 类 号：R563.9[医药卫生—呼吸系统]