| 刘 贲,刘先洪,张 楠.血清PGRN、PTX3、KL-6与经鼻高流量湿化氧疗治疗的AECOPD合并Ⅱ型呼吸衰竭患者预后关系研究[J].,2025,(18):3003-3009 |
| 血清PGRN、PTX3、KL-6与经鼻高流量湿化氧疗治疗的AECOPD合并Ⅱ型呼吸衰竭患者预后关系研究 |
| Study on the Relationship between Serum PGRN, PTX3, KL-6 and the Prognosis of Patients with AECOPD Combined with Type II Respiratory Failure after Nasal High-Flow Humidified Oxygen Therapy |
| 投稿时间：2025-03-29 |
| DOI：10.13241/j.cnki.pmb.2025.18.017 |
| 中文关键词: 经鼻高流量湿化氧疗 慢性阻塞性肺疾病急性加重期 Ⅱ型呼吸衰竭 颗粒蛋白前体 正五聚蛋白3 II型肺泡细胞表面抗原-6 预后 |
| 英文关键词: Nasal high-flow humidified oxygen therapy Acute exacerbation of chronic obstructive pulmonary disease Type Ⅱ respiratory failure Progranulin Pentraxin 3 Krebs von den lungen-6 Prognosis |
| 基金项目:四川省医学科研项目（S19046） |
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| 中文摘要: |
| 摘要 目的：探讨血清颗粒蛋白前体（progranulin, PGRN）、正五聚蛋白3（pentraxin 3, PTX3）、II型肺泡细胞表面抗原-6（krebs von den lungen-6, KL-6）与慢性阻塞性肺疾病急性加重期（acute exacerbation of chronic obstructive pulmonary disease, AECOPD）合并Ⅱ型呼吸衰竭（respiratory failure, RF）患者经鼻高流量湿化氧疗治疗后预后的关系。方法：回顾性选取2022年6月至2024年6月自贡市第一人民医院接收的160例AECOPD合并Ⅱ型RF患者，均接受经鼻高流量湿化氧疗治疗，根据患者治疗后预后情况分为死亡组（38例）、存活组（122例）。比较两组治疗前PGRN、PTX3、KL-6水平及临床资料的差异。应用Logistic回归分析患者不良预后的相关危险因素，采用受试者工作特征（receiver operating characteristic, ROC）曲线分析相关危险因素对患者不良预后的预测效能。结果：经预后评估，存活组122例（76.25%），死亡组38例（23.75%）。与存活组患者比较，死亡组患者治疗前血清PGRN、PTX3、KL-6、C反应蛋白（C-reactive protein, CRP）、动脉二氧化碳分压（arterial partial pressure of carbon dioxide, PaCO2）以及过去1年内AECOPD发作次数显著升高，而动脉氧分压（arterial partial pressure of oxygen, PaO2）显著降低，差异均具有统计学意义（P<0.05）。Logistic多因素回归分析显示，PGRN升高（OR=1.138）、PTX3升高（OR=1.182）、KL-6升高（OR=1.162）均是AECOPD合并Ⅱ型RF患者经鼻高流量湿化氧疗治疗后死亡的危险因素（P<0.05），PaO2升高（OR=0.758）是保护因素（P<0.05）。ROC曲线分析显示血清PGRN、PTX3、KL-6预测AECOPD合并Ⅱ型RF患者经鼻高流量湿化氧疗治疗后死亡的曲线下面积（area under the curve, AUC）分别为0.816、0.731、0.695，三者联合预测的AUC为0.893，显著高于单项预测。结论：血清PGRN、PTX3、KL-6在AECOPD合并Ⅱ型RF患者中水平升高，对经鼻高流量湿化氧疗治疗的AECOPD合并Ⅱ型RF患者预后不良具有较高的预测价值。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship between serum progranulin (PGRN), pentraxin 3 (PTX3), krebs von den lungen-6 (KL-6) and the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with type Ⅱ respiratory failure (RF) after nasal high-flow humidified oxygen therapy. Methods: 160 patients with AECOPD combined with type II RF who were treated in Zigong First People's Hospital from June 2022 to June 2024 were retrospectively selected, all patients received nasal high-flow humidified oxygen therapy, and they were divided into death group (38 cases) and survival group (122 cases) according to the prognosis of patients after treatment. The differences of serum PGRN, PTX3 and KL-6 levels and clinical data between two groups before treatment were compared. Logistic regression was applied to analyze the influencing factors of the poor prognosis of patients, and the receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of related risk factors for the poor prognosis of patients. Results: According to the prognosis evaluation, 122 cases (76.25%) were in survival group, and 38 cases (23.75%) were in death group. Compared with survival group, serum PGRN, PTX3, KL-6, C-reactive protein (CRP), arterial partial pressure of carbon dioxide (PaCO2) and the number of AECOPD episodes in the past 1 year before treatment in death group were significantly increased, while the arterial partial pressure of oxygen (PaO2) was significantly decreased, the differences were statistically significant (P<0.05). Logistic multivariate regression analysis showed that, elevated PGRN (OR=1.138), elevated PTX3 (OR=1.182) and elevated KL-6 (OR=1.162) were risk factors for death in patients with AECOPD combined with type II RF after nasal high-flow humidified oxygen therapy (P<0.05), and elevated PaO2 (OR=0.758) was protective factor (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of serum PGRN, PTX3 and KL-6 in predicting the death of patients with AECOPD combined with type II RF after nasal high-flow humidified oxygen therapy was 0.816, 0.731 and 0.695 respectively, the AUC of the combined prediction of the three was 0.893, which was significantly higher than that of the single prediction. Conclusion: The levels of serum PGRN, PTX3 and KL-6 in patients with AECOPD combined with type II RF are increased, which have high predictive value for the poor prognosis of patients with AECOPD combined with type II RF after nasal high-flow humidified oxygen therapy. |
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