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(P<0.05)。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(P<0.05)。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。
Objective To evaluate the role of serum vascular endothelial growth factor（ VEGF）in the prognosis of pa-tients with acute exacerbation of COPD（AECOPD）complicated with respiratory failure. Methods A total of 69 patients（52 pa-tients survived,and 17 died）with AECOPD complicated with respiratory failure who admitted to pneumology department and ICU of the First Hospital Affiliated to Guangdong Pharmaceutical College from December 2012 to December 2013,were selected as study subjects. The clinical features,levels of serum VEGF,hs-CRP and FIB,the percent of neutrophile granulocyte in pe-ripheral blood（ N）,and the results of blood-gas analysis were compared between two groups of patients,multiple Logistic re-gression was used to analyze the prognostic factors for patients with AECOPD complicated with respiratory failure. Results The age,course of COPD,smoking index,hs-CRP level,N and PaCO2 in survival group were significantly higher than those in death group,but BMI,VEGF,pH and PaO2/FiO2 in survival group were significantly lower than those in death group（ P〈0. 05 ） . Multiple Logistic regression analysis result showed that there was a marked regression relationship between levels of serum VEGF and hs-CRP,PaCO2 and the prognosis of patients with AECOPD complicated with respiratory failure（P〈0. 05）. Serum VEGF level was positively correlated with BMI（r =0. 351,P =0. 003）and arterial pH（r =0. 305,P =0. 011）,Serum VEGF level was negatively correlated with the course of COPD（r= -0. 254,P=0. 036）and arterial PaCO2（r= -0. 574,P=0. 000）. Conclusion Serum VEGF is an independent prognostic factor in patients with AECOPD complicated with respiratory failure,VEGF level is positively correlated with BMI and arterial blood pH value. Serum VEGF could be used as a marker for prognosis of patients with AECOPD complicated with respiratory failure.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第24期2797-2801,共5页
Chinese General Practice
关键词
肺疾病
慢性阻塞性
呼吸功能不全
血管内皮生长因子
预后
Pulmonary disease,chronic obstructive
Respiratory insufficiency
Vascular endothelial growth factor
Prognosis
