急性呼吸衰竭合并肺部感染老年患者血清单核细胞趋化蛋白-1、肽素的变化 ^*

Clinical significance of changes in serum monocyte chemoattractant protein-1 and copeptin levels in elderly patients with acute respiratory failure combined with pulmonary infection

摘要

目的 探究急性呼吸衰竭合并肺部感染老年患者血清单核细胞趋化蛋白-1 (MCP-1)、肽素水平变化的临床意义。方法 选取2021年1月—2023年1月内蒙古医科大学附属医院收治的212例老年急性呼吸衰竭患者作为研究对象, 依据是否发生肺部感染分为感染组 (132例) 和非感染组 (80例)。采用ELISA法检测血清MCP-1、肽素水平。使用肺功能检测仪测定用力肺活量 (FVC) 和第1秒用力呼气容积 (FEV1)。对感染组患者进行为期1年的随访, 根据预后情况分为预后不良组 (79例) 和预后良好组 (53例)。采用Pearson相关系数分析血清MCP-1、肽素水平与肺功能指标的关系。采用ROC曲线分析血清MCP-1、肽素对急性呼吸衰竭合并肺部感染老年患者预后不良的预测价值。结果 感染组血清中MCP-1、肽素水平均高于非感染组 (P<0.05)。感染组FVC、FEV1水平均低于非感染组 (P<0.05)。老年急性呼吸衰竭患者血清MCP-1、肽素水平与FVC、FEV1水平均呈负相关 (P<0.05)。预后不良组血清中MCP-1、肽素水平均高于预后良好组 (P<0.05)。血清MCP-1、肽素联合预测急性呼吸衰竭合并肺部感染老年患者预后不良的AUC高于两个指标单独预测效能 (P<0.05)。结论 MCP-1、肽素水平在急性呼吸衰竭合并肺部感染老年患者血清中呈高表达, 这两个指标有望成为该类疾病预后的监测指标。

Abstract

Objective To explore the clinical significance of changes in serum levels of monocyte chemoattractant protein-1 (MCP-1) and copeptin in elderly patients with acute respiratory failure complicated by pulmonary infection. Methods A total of 212 elderly patients with acute respiratory failure were admitted to our hospital from January 2021 to January 2023 were selected as the study subjects. They were divided into an infected group (132 cases) and a non infected group (80 cases) based on whether pulmonary infection occurred. ELISA method was applied to detect the levels of serum MCP-1 and copeptin. Pulmonary function tester was used to measure forced vital capacity (FVC) and forced expiratory volume in one second (FEV1). Patients in the infection group were followed up for 1 year and divided into poor prognosis group (79 cases) and good prognosis group (53 cases) according to the prognosis. Pearson correlation was applied to analyze the relationship between serum MCP-1, copeptin levels and lung function indicators. ROC curve was applied to analyze the predictive value of serum MCP-1 and copeptin for poor prognosis in elderly patients with acute respiratory failure complicated with pulmonary infection. Results The levels of MCP-1 and copeptin in the serum of the infected group were higher than those in the non infected group (P<0.05). The levels of FVC and FEV1 in the infected group were lower than those in the non infected group (P<0.05). The serum MCP-1 and copeptin levels in elderly patients with acute respiratory failure were negatively correlated with FVC and FEV1 levels (P<0.05). The levels of MCP-1 and copeptin in the serum of the poor prognosis group were higher than those of the good prognosis group (P<0.05). The AUC of predicting poor prognosis in elderly patients with acute respiratory failure complicated by pulmonary infection by the combination of serum MCP-1 and copeptin is higher than the predictive power of the two indicators alone (P<0.05). Conclusion MCP-1, copeptin levels are highly expressed in the serum of elderly patients with acute respiratory failure and pulmonary infection, and both are expected to become monitoring indicators for disease prognosis.

关键词

急性呼吸衰竭 / 肺部感染 / 单核细胞趋化蛋白-1 / 肽素

Key words

Acute respiratory failure / Pulmonary infection / Monocyte chemoattractant protein-1 / Copeptin

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基金资助

^*内蒙古自治区自然科学基金项目(2023MS08018)