摘要
目的探讨微小核糖核酸-210(microRNA-210,miR-210)、缺氧诱导因子-1α(hypoxia inducible factor-1α,HIF-1α)和急性生理与慢性健康Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分对慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者近期预后不良的预测价值。方法选取2019年3月至2021年6月河北省胸科医院收治的168例AECOPD患者作为观察组,另择医院同期收治的160例慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期患者作为对照组。根据治疗4周后的预后不同将观察组患者分为预后良好组(108例)和预后不良组(60例)。比较分析观察组与对照组患者、预后不良组与预后良好组患者入院时的miR-210、HIF-1α和APACHEⅡ评分。分析AECOPD患者近期预后不良的影响因素以及三种指标对AECOPD患者近期预后不良的预测价值。结果观察组患者的miR-210、HIF-1α和APACHEⅡ评分均显著高于对照组(P<0.05),且预后不良组均显著高于预后良好组(P<0.05)。多因素logistic回归分析结果显示,miR-210、HIF-1α、APACHEⅡ评分是AECOPD患者近期预后不良的独立危险因素(P<0.05)。受试者工作特征曲线分析结果显示,三种指标联合预测AECOPD患者近期预后不良的曲线下面积为0.951,高于miR-210的0.862、HIF-1α的0.865和APACHEⅡ评分的0.877(P<0.05)。三种指标联合预测的敏感度均显著高于单一指标(P<0.05)。结论血清miR-210、HIF-1α和APACHEⅡ评分均对AECOPD患者近期预后不良具有一定的预测价值,且三种指标联合预测的效能更高。
Objective To explore the predictive value of microRNA-210(miR-210),hxpoxia inducible factor-1α(HIF-1α)combined with acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)in the short-term prognosis of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Method 168 patients with AECOPD treated in Hebei Provincial Chest Hospital from March 2019 to June 2021 were selected as the observation group,and 160 patients with stable chronic obstructive pulmonary disease(COPD)treated in our hospital were selected as the control group.According to the prognosis after 4 weeks of treatment,the observation group was divided into good prognosis group(108 cases)and poor prognosis group(60 cases).The miR-210 and HIF-1α and APACHEⅡ in patients with different prognosis groups,the control group and the observation group were compared.To analyze the influencing factors of AECOPD patients with poor short-term prognosis and the predictive value of three indicators for AECOPD patients with poor short-term prognosis.Result The levels of serum miR-210,HIF-1α and APACHEⅡ scores in the observation group were higher than those in the control group(P<0.05),and the poor prognosis group was significantly higher than good prognosis group(P<0.05).miR-210,HIF-1α and APACHEⅡ scores were independent risk factors for poor prognosis in AECOPD patients(P<0.05).The area under the curve of combined prediction was 0.951,which was higher than 0.862 of miR-210,0.865 of HIF-1α and 0.877 of APACHEⅡ scores(P<0.05).The combined prediction sensitivity of three indicators was significantly higher than that of single index(P<0.05).Conclusion Serum miR-210,HIF-1α and APACHEⅡ scores have certain predictive value for poor short-term prognosis in patients with AECOPD,and the combination of the three indicators is more effective.
作者
池菲
张新
宫硕康
王晓静
张媛媛
Chi Fei;Zhang Xin;Gong Shuokang;Wang Xiaojing;Zhang Yuanyuan(Department of Emergency,Hebei Provincial Chest Hospital,Hebei Shijiazhuang 050000,China;Respiratory Department,Hebei Provincial Chest Hospital,Hebei Shijiazhuang 050000,China;Endoscopy Room,Hebei Children’s Hospital,Hebei Shijiazhuang 050000,China)
出处
《中国医刊》
CAS
2022年第7期779-782,共4页
Chinese Journal of Medicine
基金
河北省医学科学研究课题计划项目(20191015)。
