摘要
目的探讨老年慢性阻塞性肺病(COPD)合并呼吸衰竭(RF)患者血清胱抑素(CysC)、白介素-6(IL-6)、激活素A(ACTA)水平变化及与病情急性发作和预后的相关性。方法选取2020年1月至2022年5月中国人民解放军联勤保障部队第9〇4医院收治的132例老年COPD合并RF患者一般临床资料,分析对比不同疾病严重程度的老年COPD合并RF患者血清CysC、IL-6、ACTA水平,另记录患者出院3个月内急性发作再入院治疗率,将急性发作者纳入急性组,将未急性发作者纳入对照组,分析影响老年COPD合并RF患者急性发作的危险因素,记录132例老年COPD合并RF患者预后,并分析血清CysC、IL-6、ACTA水平与预后的相关性。结果CysC、IL-6、ACTA水平:Ⅳ级>Ⅲ级>Ⅱ级>Ⅰ级,差异有统计学意义(P<0.05);经Logistic回归分析发现,CysC、IL-6、ACTA是影响老年COPD合并RF患者急性发作的独立危险因素(P<0.05),将危险因素构建风险预测模型,CysC、IL-6、ACTA三者联合对老年COPD合并RF急性发作中的预测敏感度93.75%、特异度为97.36%,AUC为0.969;预后良好组血清CysC、IL-6、ACTA水平显著低于预后不良组,差异有统计学意义(P<0.05);相关性分析发现,血清CysC、IL-6、ACTA水平与老年COPD合并RF患者预后呈显著相关(P<0.05)。结论血清CysC、IL-6、ACTA是影响老年COPD合并RF患者急性发作的重要因素,其水平的监测在改善患者预后中十分关键。
Objective To investigate the changes of serum cystatin(CysC),interleukin⁃6(IL⁃6)and activin A(ACTA)levels in elderly patients with chronic obstructive pulmonary disease(COPD)complicated with respiratory failure(RF),and their correlation with acute exacerbation and the prognosis.Methods A total of 132 elderly patients with COPD and RF who were admitted to 904th Hospital of the People's Liberation Army Joint Logistic Support Force from January 2020 to May 2022 were selected as the research subjects.Serum CysC,IL⁃6 and ACTA levels in patients with different severity were comparatively analyzed.The readmission rate due to acute exacerbation within 3 months after discharge was recorded.Patients with acute exacerbation were included in the acute group,and those without were included in the control group.The risk factors for acute exacerbation in elderly patients with COPD and RF were analyzed.The correlation between serum CysC,IL⁃6 and ACTA levels and the prognosis was analyzed.Results Serum CysC,IL⁃6 and ACTA levels increased as the severity increased from gradeⅠ,gradeⅡ,gradeⅢto gradeⅣ(P<0.05).Logistic regression analysis showed that CysC,IL⁃6 and ACTA were independent risk factors for acute exacerbation in elderly patients with COPD and RF(P<0.05).A risk prediction model was constructed based on these risk factors.The sensitivity,specificity and AUC of this model in predicting acute exacerbation of COPD with RF in the elderly were 93.75%,97.36%and 0.969.Serum CysC,IL⁃6 and ACTA levels in the good prognosis group were significantly lower than those in the poor prognosis group(P<0.05).Correlation analysis showed that serum CysC,IL⁃6 and ACTA levels were correlated with the prognosis of elderly patients with COPD and RF(P<0.05).Conclusion Serum CysC,IL⁃6 and ACTA are important factors affecting the acute exacerbation in elderly patients with COPD and RF,and the monitoring of their levels is crucial to improve the prognosis of patients.
作者
马祥兵
龙超
郭健
MA Xiangbing;LONG Chao;GUO Jian(Department of Rehabilitation and Pain,Changzhou Medical District,904th Hospital of the People's Liberation Army Joint Logistic Support Force,Changzhou,Jiangsu,China,213003;Department of Internal Medicine,Changzhou Medical District,904th Hospital of the People's Liberation Army Joint Logistic Support Force,Changzhou,Jiangsu,China,213003;Department of Respiratory Medicine,Changzhou Medical District,904th Hospital of the People's Liberation Army Joint Logistic Support Force,Changzhou,Jiangsu,China,213003)
出处
《分子诊断与治疗杂志》
2023年第3期531-535,共5页
Journal of Molecular Diagnostics and Therapy
基金
江苏省卫生计生委面上项目(H2020073)。
关键词
老年
慢性阻塞性肺病
呼吸衰竭
胱抑素
白介素-6
激活素A
Elderly
Chronic obstructive pulmonary disease
Respiratory failure
Cystatin
Interleukin⁃6
Activin A
