發(fā)布時(shí)間：2018-05-07 08:12

  本文選題：肺疾病 + 慢性阻塞性��； 參考：《中國(guó)全科醫(yī)學(xué)》2014年24期

【摘要】：目的評(píng)估血清血管內(nèi)皮生長(zhǎng)因子(VEGF)在COPD急性加重期(AECOPD)并發(fā)呼吸衰竭的患者預(yù)后判定中的作用。方法選取2012年12月—2013年12月在廣東藥學(xué)院附屬第一醫(yī)院呼吸科及ICU住院的AECOPD并發(fā)呼吸衰竭患者69例,其中死亡17例,存活52例,比較2組患者的臨床特征及血清VEGF、超敏C反應(yīng)蛋白(hs-CRP)、血漿纖維蛋白原(FIB)、外周血中性粒細(xì)胞分?jǐn)?shù)(N)、血?dú)夥治鼋Y(jié)果,并采用多因素Logistic回歸分析影響AECOPD并發(fā)呼吸衰竭患者預(yù)后的因素。結(jié)果死亡組患者年齡、慢性阻塞性肺疾病(COPD)病程、吸煙指數(shù)、hs-CRP、N、二氧化碳分壓(PaCO2)均高于存活組,體質(zhì)指數(shù)(BMI)、VEGF、pH值、氧合指數(shù)(PaO2/FiO2)均低于存活組(P0.05)。多因素Logistic回歸分析結(jié)果顯示,入院血清VEGF、hs-CRP、PaCO2與AECOPD并發(fā)呼吸衰竭患者預(yù)后有回歸關(guān)系(P0.05)。血清VEGF與BMI(r=0.351,P=0.003)、動(dòng)脈血pH值(r=0.305,P=0.011)呈正相關(guān),與COPD病程(r=-0.254,P=0.036)、PaCO2(r=-0.574,P=0.000)呈負(fù)相關(guān)。結(jié)論血清VEGF是AECOPD并發(fā)呼吸衰竭患者預(yù)后的獨(dú)立預(yù)測(cè)因素,與BMI、動(dòng)脈血pH值呈正相關(guān),可作為判斷AECOPD并發(fā)呼吸衰竭患者預(yù)后的標(biāo)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.
【作者單位】： 廣東藥學(xué)院附屬第一醫(yī)院呼吸科;
【分類號(hào)】：R563.9
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本文編號(hào)：1856137