肺CT联合血清Copeptin、sTREM-1检测对COPD合并Ⅱ型呼吸衰竭患者疗效评估及预后价值  

Evaluation Value of Lung CT Combined with Serum Copeptin and sTREM-1 Detection for Curative Effect and Prognosis of Chronic Obstructive Pulmonary Disease Patients with TypeⅡRespiratory Failure

作　　者：胡苏衡 张浩 谢东升 朱勇 张娜 Hu Su-heng;Zhang Hao;Xie Dong-sheng;Zhu Yong;Zhang Na(Department of Medical Imaging,Sinopharm Gezhouba Central Hospital,Yichang 443000,Hubei Province,China;No.1 Ward of Gerontology Department,Sinopharm Gezhouba Central Hospital,Yichang 443000,Hubei Province,China)

机构地区：[1]国药葛洲坝中心医院医学影像科,湖北宜昌443000 [2]国药葛洲坝中心医院老年医学科一病区,湖北宜昌443000

出　　处：《中国CT和MRI杂志》2023年第11期70-73,共4页Chinese Journal of CT and MRI

基　　金：2021年度湖北省教育厅科学研究计划指导性项目(B20211031)。

摘　　要：目的 分析肺CT联合血清和肽素(copeptin)、可溶性髓系细胞触发受体-1(sTREM-1)检测对慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭患者疗效及预后的评估价值。方法 选取2021年1月至2022年6月在本院治疗的180例COPD合并Ⅱ型呼吸衰竭患者作为研究对象,通过对患者进行为期两周的治疗,根据治疗效果分为有效组140例、无效组4 0例。采用酶联免疫吸附(ELISA)法分别对治疗前、后患者血清中Copeptin、sTREM-1的水平进行检测。肺CT测定治疗前、后患者最大吸气末异常容积(Cvin)、最大呼气末异常体积(Cvex);Logistic回归分析影响COPD合并Ⅱ型呼吸衰竭患者预后的因素;受试者工作特征(ROC)曲线分析肺CT联合血清Copeptin、 sTREM-1水平对COPD合并Ⅱ型呼吸衰竭患者疗效及预后的评估价值。结果 治疗后,有效组患者血清Copeptin、sTREM-1及Cvin、Cves均明显降低(P<0.05),无效组无显著性变化(P>0.05),有效组较无效组患者血清Copeptin、sTREM-1及Cvin、Cvex均显著降低(P<0.05)。血清Copeptin、sTREM-1及Cvin、Cvex联合评估COPD合并Ⅱ型呼吸衰竭患者疗效的ROC曲线下面积(AUC)为0.996,优于其各自单独评估(Z二者联合-Copeptin=2.967,P=0.002;Z二者联合-sTREM-1=3.330,P=0.001;Z二者联合-Cvin=2.300,P=0.011;Z二者联合-Cvex=2.912,P=0.001)。治疗后,预后良好组患者血清Copeptin、sTREM-1及Cvin、Cvex均明显降低(P<0.05),预后不良组无显著性变化(P>0.05),预后不良组较预后良好组患者血清Copeptin、sTREM-1及Cvin、Cvex均显著升高(P<0.05)。Logistic回归分析发现, Copeptin、sTREM-1、Cvin、Cvex为影响COPD合并Ⅱ型呼吸衰竭患者预后的危险因素(P<0.05)。血清Copeptin、sTREM-1及Cvin、Cvex联合预测COPD合并Ⅱ型呼吸衰竭患者预后的AUC为0.983,优于其各自单独预测(Z二者联合-Copeptin=2.261,P=0.013;Z二者联合-sTREM-1=4.225,P<0.001;Z二者联合-Cvin=2.197,P=0.014;Z二者联合-Cvex=3.248,P=0.001)。结论 治疗后,COPD合�Objective To analyze the evaluation value of lung CT combined with serum Copeptin,soluble myeloid cell trigger receptor-1(sTREM-1)detection for curative effect and prognosis of chronic obstructive pulmonary disease(COPD)patients with typeⅡrespiratory failure.Methods A total of 180 patients with COPD combined with typeⅡrespiratory failure who were treated in our hospital from January 2021 to June 2022 were selected as the study objects.The patients were treated for two weeks,and divided into effective group of 140 patients and ineffective group of 40 patients according to the treatment effect.Enzyme linked immunosorbent assay(ELISA)was applied to detect the levels of Copeptin and sTREM-1 in serum of patients before and after treatment.The maximum inspiratory end abnormal volume(Cvin)and the maximum expiratory end abnormal volume(Cvex)of patients before and after treatment were measured by pulmonary CT;Logistic regression analysis was applied to analyze the factors influencing the prognosis of COPD patients with typeⅡrespiratory failure;ROC curve was applied to analyze the evaluation value of pulmonary CT combined with serum Copeptin and sTREM-1 levels for the efficacy and prognosis of COPD patients with typeⅡrespiratory failure.Results After treatment,the levels of serum Copeptin,sTREM-1,Cvin and Cvex in the effective group were obviously lower(P<0.05),there was no obvious change in the ineffective group(P>0.05),the levels of serum Copeptin,sTREM-1,Cvin and Cvex in the effective group were obviously lower than those in the ineffective group(P<0.05).The area under the ROC curve(AU C)of COPD patients with typeⅡrespiratory failure evaluated by the combination of serum Copeptin,sTREM-1,Cvin and Cvex was 0.996,which was superior to their respective evaluation alone(Zcombination-Copeptin=2.967,P=0.002;Zcombination-sTREM-1=3.330,P=0.001;Zcombination-Cvin=2.300,P=0.011;Zcombination-Cvex=2.912,P=0.001).After treatment,the levels of serum Copeptin,sTREM-1,Cvin and Cvex in patients with good prognosis were obviousl

关 键 词：慢性阻塞性肺疾病 Ⅱ型呼吸衰竭 COPEPTIN STREM-1 肺CT 疗效 预后 

分 类 号：R563[医药卫生—呼吸系统]