摘要
目的探讨慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭患者血清热休克蛋白27(HSP27)、亲环素A(CyPA)水平变化及其与患者预后的关系。方法选取2017年1月至2019年11月我科收治的COPD患者180例,其中COPD合并Ⅱ型呼吸衰竭患者90例(COPD合并呼吸衰竭组)、无呼吸衰竭患者90例(COPD组),另选健康体检者90例(对照组)。检测各组血清HSP27、CyPA水平;分析COPD合并呼吸衰竭患者血清HSP27、CyPA水平与FEV1%pred、FEV1/FVC和APACHEⅡ评分的相关性;采用COX比例风险回归分析COPD合并呼吸衰竭患者预后的影响因素。结果COPD合并呼吸衰竭组患者血清HSP27、CyPA高于COPD组及对照组,COPD组患者血清HSP27、CyPA高于对照组,差异有统计学意义(P<0.05)。死亡组患者的血清HSP27、CyPA高于存活组(P<0.05)。Pearson相关性分析示:患者血清HSP27、CyPA水平与FEV1%pred和FEV1/FVC呈负相关,与APACHEⅡ评分呈正相关(P<0.05)。COX回归分析示:APACHEⅡ评分、HSP27和CyPA是影响COPD合并呼吸衰竭患者预后的独立危险因素。ROC曲线示:HSP27、CyPA联合检测预测COPD合并呼吸衰竭患者预后的灵敏度和特异性分别为0.837和0.829。结论COPD合并呼吸衰竭患者血清HSP27、CyPA明显升高,与患者的病情进展及预后密切相关,对患者的病情监测和预后评估具有一定临床价值。
Objective To investigate the changes of serum heat shock protein 27(HSP27)and cyclophilin A(CyPA)levels in patients with chronic obstructive pulmonary disease(COPD)combined with typeⅡrespiratory failure and their relationship with patient prognosis.Methods 180 patients with COPD treated in our department from January,2017 to November,2019 were selected for the study,of whom 90 patients were with COPD combined with typeⅡrespiratory failure(COPD combined with respiratory failure group)and 90 patients without respiratory failure(COPD group).Ninety cases of healthy people were also selected(control group).Detections of serum HSP27 and CyPA levels in each group were conducted.We then analyzed the correlation between serum HSP27 and CyPA levels and FEV1%pred,FEV1/FVC and APACHEⅡscore in patients with COPD and respiratory failure.COX proportional hazards regression was applied to analyze the prognostic factors of COPD patients with respiratory failure.Results The serum HSP27 and CyPA of the COPD combined with respiratory failure group were higher than those of the COPD group and the control group.The serum HSP27 and CyPA of the COPD group were significantly higher than those of the control group(P<0.05).Serum HSP27 and CyPA were higher in the death group than in the survival group(P<0.05).Pearson correlation analysis showed that the serum HSP27 and CyPA levels of patients were negatively correlated with FEV1%pred and FEV1/FVC,while positively correlated with APACHEⅡscore(P<0.05).COX regression analysis showed that APACHEⅡscore,HSP27 and CyPA were independent risk factors affecting the prognosis of COPD patients with respiratory failure.The ROC curve showed that the sensitivity and specificity of HSP27 and CyPA combined detection to predict the prognosis of COPD patients with respiratory failure were 0.837 and 0.829,respectively.Conclusion The serum levels of HSP27 and CyPA in patients with COPD complicated by respiratory failure are significantly increased,which is closely related to patients’disease progression and prognosis.It has certain clinical values for the patients’disease monitoring and prognosis evaluation.
作者
高税
刘平
阳鹏
吴丹
肖东京
余纪会
GAO Shui;LIU Ping;YANG Peng;WU Dan;XIAO Dongjing;YU Jihui(Department of Respiratory and Critical Care Medicine,People’s Hospital of Changshou Chongqing,Chongqing 401220, China;Health Management Center, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China)
出处
《标记免疫分析与临床》
CAS
2021年第4期643-646,655,共5页
Labeled Immunoassays and Clinical Medicine
基金
重庆市科卫联合医学科研项目(编号:2020FYYX156)。
关键词
慢性阻塞性肺疾病
Ⅱ型呼吸衰竭
热休克蛋白27
亲环素A
Chronic obstructive pulmonary disease
TypeⅡrespiratory failure
Heat shock protein 27
Cyclophilin A
