COPD急性加重期并发呼吸衰竭患者血清血管内皮生长因子测定的意义

发布时间：2018-05-07 08:12

  本文选题：肺疾病 + 慢性阻塞性　； 参考：《中国全科医学》2014年24期

【摘要】：目的评估血清血管内皮生长因子(VEGF)在COPD急性加重期(AECOPD)并发呼吸衰竭的患者预后判定中的作用。方法选取2012年12月—2013年12月在广东药学院附属第一医院呼吸科及ICU住院的AECOPD并发呼吸衰竭患者69例,其中死亡17例,存活52例,比较2组患者的临床特征及血清VEGF、超敏C反应蛋白(hs-CRP)、血浆纤维蛋白原(FIB)、外周血中性粒细胞分数(N)、血气分析结果,并采用多因素Logistic回归分析影响AECOPD并发呼吸衰竭患者预后的因素。结果死亡组患者年龄、慢性阻塞性肺疾病(COPD)病程、吸烟指数、hs-CRP、N、二氧化碳分压(PaCO2)均高于存活组,体质指数(BMI)、VEGF、pH值、氧合指数(PaO2/FiO2)均低于存活组(P0.05)。多因素Logistic回归分析结果显示,入院血清VEGF、hs-CRP、PaCO2与AECOPD并发呼吸衰竭患者预后有回归关系(P0.05)。血清VEGF与BMI(r=0.351,P=0.003)、动脉血pH值(r=0.305,P=0.011)呈正相关,与COPD病程(r=-0.254,P=0.036)、PaCO2(r=-0.574,P=0.000)呈负相关。结论血清VEGF是AECOPD并发呼吸衰竭患者预后的独立预测因素,与BMI、动脉血pH值呈正相关,可作为判断AECOPD并发呼吸衰竭患者预后的标志物之一。
[Abstract]:Objective to evaluate the prognostic value of serum vascular endothelial growth factor (VEGF) in patients with respiratory failure in acute exacerbation of COPD. Methods from December 2012 to December 2013, 69 patients with AECOPD complicated with respiratory failure in Department of Respiratory and ICU in the first affiliated Hospital of Guangdong Pharmaceutical University were selected, 17 of them died and 52 survived. The clinical features, serum VEGF, hypersensitive C-reactive protein hs-CRP, plasma fibrinogen, peripheral blood neutrophil fraction and blood gas were compared between the two groups. Multivariate Logistic regression analysis was used to analyze the prognostic factors of patients with AECOPD complicated with respiratory failure. Results the age, duration of chronic obstructive pulmonary disease (COPD), smoking index (hs-CRPN), partial pressure of carbon dioxide (Paco _ 2) in the dead group were higher than those in the surviving group, and the body mass index (BMI) was significantly lower than that in the survival group (P < 0.05). The results of multivariate Logistic regression analysis showed that there was a regression relationship between the prognosis of patients with respiratory failure and the prognosis of patients with AECOPD complicated with respiratory failure. There was a positive correlation between serum VEGF and BMI-0.351Pu 0.003, and a negative correlation between serum VEGF and the course of COPD (P = 0.305), and a negative correlation with the course of COPD (n = 0.254), and a negative correlation between serum VEGF and the course of COPD (P = 0.574P ~ (0. 000), and a negative correlation was found between serum VEGF and the course of COPD (P ~ (0.254) P ~ (0.036) ~ (-0.574). Conclusion Serum VEGF is an independent prognostic factor in patients with AECOPD complicated with respiratory failure, which is positively correlated with AECOPD and arterial pH value. It can be used as one of the prognostic markers in patients with AECOPD complicated with respiratory failure.
【作者单位】： 广东药学院附属第一医院呼吸科;
【分类号】：R563.9
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本文编号：1856137