AECOPD并呼吸衰竭患者血骨膜蛋白、D-二聚体、内皮素-1水平变化及与预后的关系  

AECOPD changes in blood periostin,D-D,ET-1 levels and the relationship with prognosis in patients with respiratory failure

作　　者：段梦琦 殷悦 姜玉庆 Duan Mengqi;Yin Yue;Jiang Yuqing(Department of RespiratoryMedicine,960 Hospital of PLA,Jinan,Shandong;Respiratory Department of PLA General Hospital,Beijing,China)

机构地区：[1]解放军第960医院呼吸内科 [2]解放军总医院呼吸科

出　　处：《实用休克杂志(中英文)》2024年第6期342-346,355,共6页Journal of Practical Shock

基　　金：山东省医药卫生科技项目(项目编号:202303021681)

摘　　要：目的 探讨分析慢性阻塞性肺疾病急性加重期并呼吸衰竭患者血骨膜蛋白、D-二聚体、内皮素-1(ET-1)水平变化及其与预后的关系。方法 选取2022年10月至2024年8月本院收治的慢性阻塞性肺疾病急性加重期并呼吸衰竭患者90例为研究组,另选取本院同期收治的单纯慢性阻塞性肺疾病急性加重期患者90例为对照组,比较两组血骨膜蛋白、D-二聚体、ET-1水平及急性生理与慢性健康评分Ⅱ(APACHEⅡ)情况,采用Pearson相关性分析上述指标与APACHEⅡ评分的关系。追踪研究组患者3个月内的预后情况,并将其分为预后良好组和预后不良组,收集两组患者临床资料,多因素Logistic回归分析影响慢性阻塞性肺疾病急性加重期并呼吸衰竭患者预后不良的危险因素,绘制受试者工作特征(ROC)曲线分析血骨膜蛋白、D-二聚体、内皮素-1水平对患者预后不良的预测价值。结果 研究组患者血骨膜蛋白、D-二聚体、ET-1及APACHEⅡ评分均高于对照组(P<0.05);Pearson相关性分析显示,血骨膜蛋白、D-二聚体、内皮素-1水平均与APACHEⅡ评分呈正相关(r=0.491、0.423、0.462,P均<0.05)。经3个月随访,90例患者预后不良患者19例,预后良好71例。预后良好组和预后不良组的年龄、性别、体质量指数、合并高血压、合并高血脂比较差异均无统计学意义(P>0.05);预后不良组糖尿病占比、血骨膜蛋白、D-二聚体、ET-1水平及APACHEⅡ评分均高于预后良好组(P<0.05)。多因素Logistic回归分析,结果显示血骨膜蛋白、D-二聚体、内皮素-1水平升高均为影响患者预后不良的危险因素(OR=3.846、3.622、3.728,P<0.05)。ROC结果显示,血骨膜蛋白、D-二聚体、内皮素-1水平及其联合检测预测慢性阻塞性肺疾病急性加重期并呼吸衰竭患者预后不良的曲线下面积(AUC)分别为0.772、0.762、0.787和0.914(P均<0.05)。结论 血骨膜蛋白、D-二聚体、ET-1水平在慢性阻塞性肺疾�Objective To analyze the changes and the relationship of blood periostin,D-dimer,and endothelin-1in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and respiratory failure.Methods 90patients with AECOPD and respiratory failure admitted to our hospital from October 2022to August 2024,and 90patients with simple AECOPD admitted to the same period in our hospital as the control group to compare the blood periostin,D-dimer,endothelin-1levels and acute physiology and chronic health scoreⅡ(APACHEⅡ)between the Pearson and APACHEⅡscore.Tracing the prognosis of the study group patients within 3months,They were divided into good prognosis and poor prognosis,clinical data of two groups were collected,multivariate Logistic regression analyzed the risk factors that affected the poor prognosis of patients with AECOPD and respiratory failure,and subject working characteristic(ROC)curve was drawn to analyze the predictive value of blood periostin,D-dimer and endothelin-1level on poor prognosis of patients with AECOPD and respiratory failure.Results The scores of blood periostin,D-dimer,endothelin-1 and APACHEⅡwere higher than the control group(P<0.05);Pearson correlation analysis showed that blood periostin,D-dimer,and endothelin-1levels were positively correlated with APACHEⅡscores(r=0.491,0.423,0.462,P<0.05).After a 3-month follow-up,90patients with AECOPD and respiratory failure had 19poor prognosis,and 71patients had a good prognosis.The age,sex,body quality index,hypertension,and hyperlipidemia in the good and poor prognosis groups were not significant(P>0.05);the diabetes proportion,blood periostin,D-dimer,endothelin-1level,and APACHEⅡscore were all higher than the good prognosis group(P<0.05).In multivariate Logistic regression analysis,the results showed that increased blood periostin,D-dimer and endothelin-1levels were all risk factors affecting the poor prognosis of patients with AECOPD and respiratory failure(OR=3.846、3.622、3.728,P<0.05)。ROC results showed that the are

关 键 词：慢性阻塞性肺疾病急性加重期 呼吸衰竭 血骨膜蛋白 D-二聚体 内皮素-1 

分 类 号：R563.8[医药卫生—呼吸系统] R563.9[医药卫生—内科学]