|
|
Correlation analysis between serum HMGB1, α1-AT and AECOPD complicated with respiratory failure and the prognosis |
HAO Yuyu, LI Congsheng, WANG Yong |
Department of Emergency, The Third Affiliated Hospital of Anhui Medical University/the First People's Hospital of Hefei, Hefei 230001, China |
|
|
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.
|
Received: 21 May 2024
|
|
|
|
[1] GRAUMAM RQ, PINHEIRO MM, SZEJNFELD VL, et al.High rate of abdominal aortic calcification in COPD patients and its relationship with musculoskeletal fragility[J]. Osteoporos Int, 2023, 34(1): 69-79. [2] 栗春丽, 卓致远, 李军. 孟鲁司特对慢性阻塞性肺疾病急性加重期患者肺功能的影响[J]. 西北药学杂志, 2022, 37(3): 171-175. [3] 康睿, 刘慧霞. 肺部感染控制窗序贯通气在慢性阻塞性肺疾病急性加重期合并呼吸衰竭治疗中的应用价值研究[J]. 陕西医学杂志, 2022, 51(3): 342-346. [4] HYAMS C, QIAN G, NAVA G, et al.Impact of SARS-CoV-2 infective exacerbation of chronic obstructive pulmonary disease on clinical outcomes in a prospective cohort study of hospitalised adults[J]. J R Soc Med, 2023, 116(11): 371-385. [5] 唐文君, 曾珠, 杨帆, 等. 血清HMGB1与COPD急性加重期患者炎性指标肺功能参数之间的相关性[J]. 河北医学, 2023, 29(10): 1649-1654. [6] ROCHE SM, CARROLL TP, FRAUGHEN DD, et al.Alpha-1 Antitrypsin Deficiency and Smoking Cessation: Tackling the Burden of COPD One Test at a Time?[J]. Chest, 2023, 163(4): e197. [7] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组, 中国医师协会呼吸医师分会慢性阻塞性肺疾病工作委员会. 慢性阻塞性肺疾病诊治指南 (2021年修订版)[J]. 中华结核和呼吸杂志, 2021, 44(3): 170-205. [8] ADLER D, JANSSENS JP.The Pathophysiology of Respiratory Failure: Control of Breathing, Respiratory Load, and Muscle Capacity[J]. Respiration, 2019, 97(2): 93-104. [9] 顾明豪, 郭忠, 程梓晗. 肺功能测试参数联合CAT评分对老年慢性阻塞性肺疾病患者急性发作的预测价值[J]. 海军医学杂志, 2023, 44(12): 1232-1236. [10] 刘佳敏, 谢逍, 李梅. 血清pro-BNP hs-CRP FIB水平对AECOPD合并呼吸衰竭的诊断及预后评估研究[J]. 河北医学, 2023, 29(5): 849-855. [11] 孙金昊, 刘晓飞, 李香兰, 等. 经鼻高流量氧疗治疗AECOPD合并轻度Ⅱ型呼吸衰竭对患者血气分析指标及CTGF、ET-1、TGF-β1指标水平的影响[J]. 临床和实验医学杂志, 2022, 21(11): 1148-1152. [12] WONG EKC, LEE PCS, ANSARY S, et al.Role of venous blood gases in hypercapnic respiratory failure chronic obstructive pulmonary disease patients presenting to the emergency department[J]. Intern Med J, 2019, 49(7): 834-837. [13] 翁光平, 邱丽莉, 王艳波. 血清白细胞介素-37与慢性阻塞性肺疾病急性加重期并发呼吸衰竭患者预后的相关性[J]. 中华实用诊断与治疗杂志, 2022, 36(1): 54-58. [14] ZHAN Y, LING Y, DENG Q, et al.HMGB1-Mediated Neutrophil Extracellular Trap Formation Exacerbates Intestinal Ischemia/Reperfusion-Induced Acute Lung Injury[J]. J Immunol, 2022, 208(4): 968-978. [15] 张婧, 龙瀛, 郑相如, 等. 慢性阻塞性肺疾病患者外周血及肺组织中高迁移率族蛋白1和Th17/Treg的变化及意义[J]. 医学研究生学报, 2022, 35(10): 1039-1044. [16] 鄞晓斌, 邱名耀, 吴海琴, 等. 血清α1-AT和NE水平变化与AECOPD患者病情程度关系及预测呼吸衰竭的价值[J]. 临床急诊杂志, 2022, 23(6): 390-394. [17] 黄振, 刘乃嘉. 血乳酸联合APACHE Ⅱ评分预测慢性阻塞性肺疾病急性加重期并呼吸衰竭预后的价值[J]. 局解手术学杂志, 2023, 32(9): 795-799. [18] 娄海玲. 血清HMGB1、IL-2和Copeptin水平变化与COPD合并Ⅱ型呼吸衰竭患者病情严重程度及疾病转归的关系[J]. 检验医学与临床, 2022, 19(9): 1163-1165+1169. [19] 周宇阳, 杨军杰. α1-AT/DNase Ⅰ、HBD-1、SF在重症儿童社区获得性肺炎患儿中的表达及其临床意义[J]. 医学临床研究, 2023, 40(8): 1211-1213+1217. [20] 叶晓, 凌雪, 林佳雨, 等. α1-抗胰蛋白酶——一种可抵抗SARS-CoV-2细胞侵袭的多功能蛋白的研究进展[J]. 中国细胞生物学学报, 2023, 45(3): 374-382. |
|
|
|