摘要
目的探讨血清胱抑素C(CysC)、血管内皮生长因子(VEGF)、白细胞介素17(IL⁃17)、激活素A(ACTA)在老年慢性阻塞性肺疾病(COPD)伴严重呼吸衰竭患者中的表达。方法选取2016年3月至2019年3月本院224例老年COPD患者,根据有无发生严重呼吸衰竭分组观察组(n=78)、轻症组(n=146),另选取同期健康体检者86例为对照组。比较3组不同预后患者血清CysC、VEGF、IL⁃17、ACTA水平,分析血清指标对老年COPD伴严重呼吸衰竭的诊断价值及血清指标间相关性,并分析血清指标与APACHEⅡ评分相关性及预后预测价值。结果3组血清CysC、VEGF、IL⁃17、ACTA水平,差异有统计学意义(P<0.05);VEGF与Cys C、IL⁃17、ACTA水平呈负相关,CysC、IL⁃17、ACTA间水平呈正相关(P<0.05);死亡患者血清CysC、IL⁃17、ACTA水平、APACHEⅡ评分高于存活患者,VEGF水平低于存活患者(P<0.05);VEGF水平与APACHEⅡ评分呈负相关,CysC、IL⁃17、ACTA水平与APACHEⅡ评分呈正相关(P<0.05);血清CysC、VEGF、IL⁃17、ACTA水平联合对预测老年COPD伴严重呼吸衰竭预后的AUC(0.864)大于单一血清指标,敏感性为92.86%,特异性为70.00%。结论血清CysC、VEGF、IL⁃17、ACTA水平在老年COPD伴严重呼吸衰竭患者中呈异常表达,并与病情密切相关,联合检测有望成为老年COPD伴严重呼吸衰竭诊断及预后判断的有效手段。
Objective To investigate the expression of serum cystatin C(CysC),vascular endo⁃thelial growth factor(VEGF),interleukin 17(IL⁃17)and activin A(ACTA)in elderly patients with chronic obstructive pulmonary disease(COPD)with severe respiratory failure.Methods 224 elderly patients with COPD were selected in our hospital from March 2016 to March 2019,according to the occurrence of severe re⁃spiratory failure,they were divided into an observation group(n=78)and a control group(n=146),and 86 healthy medical examinees in the same period were selected as the healthy control group.Compared the serum CysC,VEGF,IL⁃17 and ACTA levels of patients with different prognosis in the three groups and the observation group,and analyzed the diagnostic value of serum indicators for elderly COPD with severe respiratory fail⁃ure and the correlation between serum indicators,and the correlation between serum indicators and APACHEⅡscore and the prognostic value were analyzed.Results The levels of serum CysC,VEGF,IL⁃17,and ACTA in the three groups were statistically significant(P<0.05);VEGF was negatively correlated with CysC,IL⁃17,and ACTA levels,and CysC,IL⁃17,and ACTA levels were positively correlated(P<0.05);the serum levels of CysC,IL⁃17,ACTA,and APACHEⅡscore were higher in dead patients than in surviving patients,and VEGF levels were lower than in surviving patients(P<0.05);VEGF level was negatively correlated with APACHEⅡscore,and CysC,IL⁃17,and ACTA levels were positively correlated with APACHEⅡscore(P<0.05);the combined serum levels of CysC,VEGF,IL⁃17,and ACTA in predicting the prognosis of COPD with severe respiratory failure in elderly patients(0.864)was greater than that of a single serum indicator,with a sensitivity of 92.86%and a specificity of 70.00%.Conclusion Serum CysC,VEGF,IL⁃17,and ACTA levels are abnormally expressed in elderly patients with COPD and severe respiratory failure,and are closely related to the disease,and the combined detection is expected to be an effective method for diagnosis and prognosis of elderly COPD with severe respiratory failure.
作者
曹婷婷
万俊
冯永海
楚荷莹
CAO Tingting;WAN Jun;FENG Yonghai;CHU Heying(Department of general medicine,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan,China,450052;Department of respiratory medicine,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan,China,450052;Department of respiratory medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan,China,450052)
出处
《分子诊断与治疗杂志》
2020年第4期533-537,共5页
Journal of Molecular Diagnostics and Therapy
基金
河南省高等学校重点科研项目(19A320065)。
