Clinical significance of serum APC and HO-1 levels in patients with AECOPD with type Ⅱ respiratory failure treated with non-invasive mechanical ventilation
10.3969/j.issn.1673-4130.2024.24.004
- VernacularTitle:AECOPD合并Ⅱ型呼吸衰竭无创机械通气治疗患者血清APC、HO-1水平的临床意义研究
- Author:
Lin LYU
1
;
Chunying SHEN
;
Li LIU
;
Jianhong LIU
;
Haixia WANG
Author Information
1. 攀枝花市第二人民医院呼吸科,四川攀枝花 617000
- Keywords:
acute exacerbation of chronic obstructive pulmonary disease;
type Ⅱ respiratory failure;
non-invasive mechanical ventilation;
activated protein c;
heme oxygenase-1
- From:
International Journal of Laboratory Medicine
2024;45(24):2961-2966
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical significance of serum activated protein C(APC)and heme ox-ygenase-1(HO-1)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with type Ⅱ respiratory failure treated with non-invasive mechanical ventilation(NIV).Methods A total of 265 AECOPD patients with type Ⅱ respiratory failure admitted to the Second People's Hospital of Panzhihua City from April 2021 to April 2023 were selected as the study group,and another 200 stable chronic obstruc-tive pulmonary disease(COPD)patients and 200 healthy individuals were selected as the stable COPD group and healthy group.The serum APC and HO-1 levels of the three groups were compared.After receiving NIV treatment,the study group was divided into a poor prognosis group(40 cases)and a good prognosis group(225 cases)based on their prognosis within 28 days.General information,laboratory indicators,and serum APC and HO-1 levels were compared between the two groups.Multivariate Logistic regression model was used to analyze the influencing factors of poor prognosis.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of serum APC and HO-1 in predicting patient prognosis.Results Compared with the healthy group,serum APC levels decreased in the stable COPD group,serum HO-1 levels increased(P＜0.05).Compared with the stable COPD group,serum APC levels decreased in the study group,serum HO-1 levels increased(P＜0.05).Compared with the good prognosis group,serum APC,pH,arterial oxygen partial pressure(PaO2)before NIV decreased in the poor prognosis group,serum HO-1,arterial partial pressure of carbon dioxide(PaCO2)levels,acute physiology and chronic health evaluation(APACHE)Ⅱ scores increased(P＜0.05).The results of the multivariate Logistic regression model showed that PaCO2,APACHE Ⅱ score and HO-1 elevated were risk factors for poor patient prognosis,while the Forced Expiratory Volume in 1 Sec-ond/excepted value(FEV1％Pred),forced expiratory volume in the first second/forced vital capacity(FEV1/FVC),PaO2,APC,pH elevated were protective factors(P＜0.05).ROC curve results showed that the area under the curve,sensitivity and specificity of the combined detection of two indicators for predicting poor prognosis in AECOPD patients with type Ⅱ respiratory failure treated with NIV were 0.914,87.50％and 94.22％respectively,which were significantly better than those of single indicator detection.Conclusion The decrease of serum APC level and the increase of serum HO-1 level are relate to the poor prognosis of AECO-PD patients with type Ⅱ respiratory failure treated with NIV,detection of serum APC combine with HO-1 has relatively high predictive value for the poor prognosis of the patients.
