Abstract：Objective To explore the correlation between serum high mobility group box 1(HMGB1), alpha-1 antitrypsin (alpha1-AT) and acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with respiratory failure (RF) and the prognosis. Methods A total of 80 patients with AECOPD and RF who were admitted to the hospital from July 2020 to July 2023 were selected as the observation group. Meanwhile, 50 patients with simple AECOPD were selected as the control group. Serum HMGB1 and alpha1-AT levels of the two groups were compared. Patients in the observation group were divided into good prognosis group and poor prognosis group. The prognostic factors in patients with AECOPD and RF were explored. The prognostic value of serum HMGB1 and alpha1-AT in patients with AECOPD and RF was analyzed using the receiver operating characteristic (ROC) curves. Results Serum HMGB1 and alpha1-AT levels in the observation group were higher than those in the control group. In this study, 22(27.50%) of 80 patients with AECOPD and RF had poor prognosis. Course of disease, CAT score, and serum HMGB1 and alpha1-AT levels in the poor prognosis group were higher than those in the good prognosis group. CAT score, serum HMGB1 and alpha1-AT levels were independent prognostic factors in patients with AECOPD and RF. Pearson correlation analysis results showed that CAT score of patients with AECOPD and RF was positively correlated with serum HMGB1 and alpha1-AT levels. ROC curves indicated that the optimal cutoff values of serum HMGB1 and alpha1-AT levels for predicting the prognosis of patients with AECOPD and RF were 179.925 μg/L and 14.710 mg/L, respectively. The AUC and specificity of combined prediction were 0.869 and 96.60%, both of which were higher than those of prediction using a single indicator. Conclusion Compared to patients with simple AECOPD, patients with AECOPD and RF have higher serum levels of HMGB1 and alpha1-AT. HMGB1 and alpha1-AT are independent prognostic factors in patients with AECOPD and RF, and HMGB1 combined with alpha1-AT is of high value in the prognosis of AECOPD with RF.
2024, Vol. 21 
