COPD急性加重期患者血清miR-146表达及其与并发呼吸衰竭的关系  

Serum miR-146 expression in patients with acute exacerbation of COPD and concurrent respiratory failure

作　　者：王丹平[1] 孟凡亮[1] 朱洪斌[1] 颜刚林 范小玉 WANG Danping;MENG Fanliang;ZHU Hongbin;YAN Ganglin;FAN Xiaoyu(Department of Respiratory and Critical Care,Chaohu Hospital Affiliated to Anhui Medical University,Hefei 238000,Anhui,China)

机构地区：[1]安徽医科大学附属巢湖医院呼吸与危重症医学科,安徽合肥238000

出　　处：《皖南医学院学报》2025年第2期145-148,共4页Journal of Wannan Medical College

基　　金：教育部高等学校科技研究项目(KJ2018A0667)。

摘　　要：目的:探究慢性阻塞性肺疾病(COPD)急性加重期患者血清微小核糖核酸-146(miR-146)表达及其与并发呼吸衰竭的关系。方法:选取2021年1月~2023年12月安徽医科大学附属巢湖医院呼吸科收治的80例老年COPD急性加重期患者作为研究组,并选取40例老年COPD稳定期患者作为对照组。检测所有研究对象血清miR-146表达情况。分析血清miR-146表达与老年COPD急性加重期患者COPD分级、血气水平的相关性。观察研究组患者呼吸衰竭并发情况,将其分为并发组与未并发组,对比两组血清miR-146表达。采用多因素Logistic回归性分析法分析老年COPD急性加重期伴呼吸衰竭患者的影响因素。结果:研究组血清miR-146表达低于对照组(P<0.05)。血清miR-146表达与老年COPD急性加重期患者COPD分级、动脉血二氧化碳分压(PaCO_(2))均呈负相关(P<0.05),与动脉血氧分压(PaO_(2))、氧合指数均呈正相关(P<0.05);并发组急性加重期病程、COPD分级Ⅳ级占比及血肌酐(Scr)、C反应蛋白(CRP)水平高于未并发组(P<0.05),血清miR-146表达低于未并发组(P<0.05);多因素Logistic回归分析显示,急性加重期病程长,COPD分级为Ⅳ级,Scr、CRP表达水平高均是老年COPD急性加重期患者并发呼吸衰竭的危险因素(P<0.05),而血清miR-146高表达是其保护因素(P<0.05);血清miR-146表达对老年COPD急性加重期患者并发呼吸衰竭评估的最佳截断点(cut-off值)、灵敏度、特异度、曲线下面积(AUC)分别为0.51、80.00%、78.33%、0.846(95%CI:0.748~0.917)。结论:老年COPD急性加重期患者血清miR-146表达异常降低,且在并发呼吸衰竭患者中低于未并发者,且其越低,患者并发呼吸衰竭的风险越高,对老年COPD急性加重期伴呼吸衰竭患者具有一定的临床评估价值。Objective:To investigate the expression of serum microRNA-146(miR-146)in patients with acute exacerbations of chronic obstructive pulmonary disease(COPD)and its relationship with concurrent respiratory failure.Methods:Eighty elderly patients with acute exacerbations of COPD treated in the Respiratory Department of our hospital between January 2021 and December 2023 were included in the study group,and another 40 elderly patients with stable COPD who visited our hospital were recruited as controls(control group).All patients underwent measurement of serum miR-146 expression,and the correlation between serum miR-146 expression and COPD severity,blood gas levels was analyzed in the patients with acute exacerbation of COPD.Additionally,patients in the study group were further divided into a concurrent respiratory failure group and a non-concurrent group based on the occurrence of respiratory failure,and serum miR-146 expression was compared between the two groups.Multivariate logistic regression analysis was conducted to identify factors causing respiratory failure in this group of patients.Results:Serum miR-146 expression was lower in the study group compared to the control group(P<0.05),and negatively correlated with COPD severity and PaCO_(2)(P<0.05),yet positively PaO_(2)and oxygenation index(P<0.05)in patients with acute exacerbations of COPD.Patients in the concurrent respiratory failure group had longer acute exacerbation duration,higher proportion of stage IV of COPD,higher levels of serum creatinine(Scr)and C-reactive protein(CRP),yet lower serum miR-146 expression compared to the non-concurrent group(P<0.05).Multivariate logistic regression analysis revealed that longer acute exacerbation duration,COPD at stage IV,high levels of Scr and CRP were risk factors for concurrent respiratory failure in elderly patients with acute exacerbations of COPD(P<0.05),whereas high serum miR-146 expression was a protective factor(P<0.05).The optimal cut-off value,sensitivity,specificity,and area under the curve(AUC)of serum

关 键 词：慢性阻塞性肺疾病 微小核糖核酸-146 呼吸衰竭 

分 类 号：R563.9[医药卫生—呼吸系统] R446.11[医药卫生—内科学] R563.8[医药卫生—临床医学]