COPD并Ⅱ型呼吸衰竭患者HIF-1α、SP-D、Copeptin水平及价值

The Levels and Value of HIF-1α, SP-D, and Copeptin in COPD Patients with Type II Respiratory Failure

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缺氧诱导因子1α（HIF-1α）、肺表面活性物质蛋白D（SP-D）、和肽素（Copeptin）水平变化,分析其对预后的预测价值。方法 选取2020年1月~2023年1月中国人民解放军联勤保障部队第九八八医院收治的COPD合并Ⅱ型呼吸衰竭患者120例为研究对象,依据治疗28 d内生存情况分为预后不良组、预后良好组。比较2组临床资料及血清HIF-1α、SP-D、Copeptin水平。采用受试者工作特征曲线（ROC）分析血清指标对预后的预测价值。结果 治疗7 d后,预后不良组血清HIF-1α、SP-D、Copeptin水平高于预后良好组（P<0.05）;血清HIF-1α、SP-D、Copeptin与APACHEⅡ评分、cTnT、NT-proBNP、CRP呈正相关（P<0.05）;HIF-1α+SP-D+Copeptin联合预测预后的AUC分别大于单项指标预测、任意两项指标联合预测（P<0.05）。结论 血清HIF-1α、SP-D、Copeptin水平升高与COPD合并Ⅱ型呼吸衰竭患者预后不良、病情严重程度密切相关,其在预测预后方面具有重要临床意义。

Abstract

Objective To investigate the changes of serum hypoxia-inducing factor 1α (HIF-1α), pulmonary surfactant protein D (SP-D), and Copeptin levels in patients with chronic obstructive pulmonary disease (COPD) complicated with type II respiratory failure, and to analyze their prognostic value. Methods A total of 120 patients with COPD combined with type II respiratory failure admitted to 988 Hospital of Chinese People's Liberation Army Joint Logistic Support Force from January 2020 to January 2023 were selected as the study objects, and were divided into poor prognosis group and good prognosis group according to the survival status within 28 days of treatment. Compare clinical data and serum levels of HIF-1 , SP-D, and Copeptin between two groups. Use receiver operating characteristic curve (ROC) to analyze the predictive value of serum indicators for prognosis. Results After 7 days of treatment, the serum levels of HIF-1α, SP-D, and Copeptin in the poor prognosis group were higher than those in the good prognosis group (P<0.05); the serum levels of HIF-1α, SP-D, and Copeptin were positively correlated with APACHE II score, cTnT, NT proBNP, and CRP (P<0.05); the AUC predicted by HIF-1α+SP-D+Copeptin was higher than that predicted by single index and predicted by any two indexes (P<0.05). Conclusion The increase of serum HIF-1α, SP-D and Copeptin levels is closely related to poor prognosis and severity of COPD patients with type 2 respiratory failure, which has important clinical significance in predicting prognosis.

关键词

慢性阻塞性肺疾病 / Ⅱ型呼吸衰竭 / 缺氧诱导因子1α / 肺表面活性物质蛋白D / 和肽素

Key words

Chronic obstructive pulmonary disease / Type II respiratory failure / Hypoxia inducible factor 1α / Pulmonary surfactant protein D / Vasopeptin

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