血清HDAC2和SP-D对经鼻高流量氧疗治疗慢性阻塞性肺疾病急性加重期合并轻中度Ⅱ型呼吸衰竭患者预后的诊断价值

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摘要目的探讨血清组蛋白脱乙酰酶2（HDAC2）和肺表面活性物质蛋白D（SP-D）对经鼻高流量氧疗治疗慢性阻塞性肺疾病急性加重期（AECOPD）合并轻中度Ⅱ型呼吸衰竭患者预后的诊断价值。方法选取2018年1月至2020年12月河北省胸科医院呼吸科收治的AECOPD合并轻中度Ⅱ型呼吸衰竭患者312例，所有患者均接受常规治疗及经鼻高流量氧疗，依据治疗14 d后的转归情况将其分为稳定组（224例）和加重组（88例）。收集患者一般资料及治疗前血清HDAC2、SP-D水平，分析经鼻高流量氧疗治疗AECOPD合并轻中度Ⅱ型呼吸衰竭患者预后的影响因素。采用受试者操作特征曲线及曲线下面积（AUC）分析治疗前血清HDAC2和SP-D水平对患者预后的诊断价值。结果加重组急性生理学和慢性健康状况评价Ⅱ（APACHEⅡ）评分、白细胞计数、中性粒细胞计数、C反应蛋白、红细胞沉降率、降钙素原、治疗前血清HDAC2、治疗前血清SP-D均高于稳定组，差异有统计学意义（P ＜ 0.05）。多因素分析结果显示，APACHEⅡ评分、治疗前血清HDAC2、治疗前血清SP-D水平为AECOPD合并轻中度Ⅱ型呼吸衰竭患者经鼻高流量氧疗14 d后预后的影响因素（P ＜ 0.05）。治疗前血清HDAC2、SP-D水平对AECOPD合并轻中度Ⅱ型呼吸衰竭患者经鼻高流量氧疗治疗14 d的预后具有一定的诊断价值（AUC ＞ 0.5，P ＜ 0.05）。结论血清HDAC2和SP-D水平与AECOPD合并轻中度Ⅱ型呼吸衰竭患者经鼻高流量氧疗治疗14 d的预后有一定的相关性，具有一定的诊断价值。

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	李江涛王媛王亮孟静李艳君

关键词 ：组蛋白脱乙酰酶2, 肺表面活性物质蛋白D, 经鼻高流量氧疗, 慢性阻塞性肺疾病急性加重期, 呼吸衰竭, 预后

Abstract：Objective To investigate the diagnostic value of serum histone deacetylase 2 (HDAC2) and pulmonary surfactant protein D (SP-D) in the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with mild to moderate type Ⅱ respiratory failure treated by nasal high flow oxygen therapy. Methods A total of 312 patients with AECOPD complicated with mild to moderate type Ⅱ respiratory failure admitted to the Department of Respiratory, Hebei Chest Hospital from January 2018 to December 2020 were selected. All patients received conventional treatment and nasal high flow oxygen therapy, and they were divided into stable group (224 cases) and recombination group (88 cases) according to the outcome after 14 days of treatment. General data, serum HDAC2, and SP-D levels before treatment were collected and compared to analyze the prognostic factors of patients with AECOPD complicated with mild to moderate type Ⅱ respiratory failure treated with nasal high flow oxygen therapy. Receiver operating characteristic curve and area under curve (AUC) were used to analyze the diagnostic value of serum HDAC2 and SP-D levels before treatment for prognosis of patients. Results The acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) score, white blood cell count, neutrophil count, C-reactive protein, erythrocyte sedimentation rate, procalcitonin, serum HDAC2 before treatment, and serum SP-D before treatment in the recombination group were higher than those in the stable group, and the differences were statistically significant (P ＜ 0.05). The results of multivariate analysis showed that APACHE Ⅱ score, serum HDAC2 before treatment, and serum SP-D level before treatment were the influencing factors of the prognosis of AECOPD with mild to moderate type Ⅱ respiratory failure after 14 days of nasal high flow oxygen therapy (P ＜ 0.05). Serum HDAC2 and SP-D levels before treatment had certain diagnostic value for the prognosis of AECOPD patients with mild to moderate type Ⅱ respiratory failure after 14 days of nasal high flow oxygen therapy (AUC ＞ 0.5, P ＜ 0.05). Conclusion Serum HDAC2 and SP-D levels are correlated with the prognosis of AECOPD patients with mild to moderate type Ⅱ respiratory failure after 14 days of nasal high flow oxygen therapy, which has certain diagnostic value.

Key words： Histone deacetylase 2 Pulmonary surfactant protein D Nasal high flow oxygen therapy Acute exacerbation of chronic obstructive pulmonary disease Respiratory failure Prognosis

基金资助:河北省医学科学研究重点课题计划项目（20200 828）。

通讯作者: 李艳君（1975.2-），女，副主任医师；研究方向：呼吸睡眠疾病的临床研究。

引用本文:

李江涛王媛王亮孟静李艳君. 血清HDAC2和SP-D对经鼻高流量氧疗治疗慢性阻塞性肺疾病急性加重期合并轻中度Ⅱ型呼吸衰竭患者预后的诊断价值[J]. 中国医药导报, 2022, 19(10): 25-29.
LI Jiangtao WANG Yuan WANG Liang MENG Jing LI Yanjun. Diagnostic value of serum HDAC2 and SP-D in the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease combined with mild to moderate type Ⅱ respiratory failure treated by nasal highflow oxygen therapy#br#. 中国医药导报, 2022, 19(10): 25-29.

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[1] Vogelmeier CF，Criner GJ，Martinez FJ，et al. Global strategy for the diagnosis，management，and prevention of chronic obstructive lung disease 2017 report：GOLD executive summary [J]. Am J Respir Crit Care Med，2017， 195：557-582.
[2] 慢性阻塞性肺疾病急性加重（AECOPD）诊治专家组.慢性阻塞性肺疾病急性加重诊治中国专家共识（草案）[J].中国呼吸与危重监护杂志，2013，12（6）：541-551.
[3] Putcha N，Drummond MB，Wise RA，et al. Comorbidities and chronic obstructive pulmonary disease：prevalence influence on outcomes and management [J]. Semin Respir Crit Care Med，2015，36（4）：575-591.
[4] Yang G，Wang Y，Zeng Y，et al. Rapid health transition in China，1990—2010：findings，form the Global，Burden of Diseasase Study，2010 [J]. Lancet，2013，381（9882）：1987-2015.
[5] Pauwels RA，Buist AS，Calverley PM，et al. Global strategy for the diagnosis，management，and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease（GOLD）Workshop summary [J]. Am J Respir Crit Care Med，2001，163（5）：1256-1276.
[6] Tamimi A，Serdarevic D，Hanania NA. The efects of cigarette smoke on airway inflammation in asthma and COPD：themapeutic implications [J]. Respir Med，2012，106（3）：319-328.
[7] Sorensen GL，Husby S，Holmskov U. Surfactant protein A and surfactant protein D variation in pulmonary disease [J]. Immunobiology，2007，212（4-5）：381-416.
[8] 柴书坤.经鼻高流量加温湿化吸氧治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的临床研究[D].石家庄：河北医科大学，2016：8-23.
[9] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南（2019年修订版）[J].中华结核和呼吸杂志，2019，36（4）：255-264.
[10] Hung KC，Lin HJ，Hsieh SW，et al. Impact of intervention time on hospital survival in patients requiring emergent airway management：a preliminary study [J]. J Anesth，2018，32（2）：153-159.
[11] 刘长庭.慢性阻塞性肺疾病全球创议（2011修订版）解读[J].中华保健医学杂志，2013，15（1）：79-84.
[12] GBD 2015 Mortality and Causes of Death Collaborators. Global，regional，and national life expectancy，all-cause mortality，and cause-specific mortality for 249 causes of death，1980—2015：a systematic analysis for the Global Burden of Disease Study 2015 [J]. Lancet，2016，388（10053）：1459-1544.
[13] 谢俊刚.AECOPD在临床诊治中存在的核心问题[J].内科急危重症杂志，2016，22（5）：329-331.
[14] Hurst JR，Wedzicha JA. Management and prevention of chronic obstructive pulmonary disease exacerbations：a state of the art review [J]. BMC Med，2009，7：40.
[15] 中华医学会，中华医学会杂志社，中华医学会全科医学会，等.慢性治性肺疾病基层诊疗指南（2018）[J].中华全科医师杂志，2018，17（11）：856-870.
[16] 万晓旭，赵月环，刘秀春，等.肺功能检测技术与临床应用研究现状[J].社区医学杂志，2018，16（21）：1618-1622.
[17] 何权瀛.规范肺功能测定技术，提高肺功能测定水平[J].中华结核和呼吸杂志，2006（12）：793-795.
[18] Godinjak A，Iglica A，Rama A，et al. Predictive value of SAPS Ⅱ and APACHE Ⅱ scoring systems for patient outcome in a medical intensive care unit [J]. Acta Med Acad，2016，45（2）：97-103.
[19] Ito K，Ito M，Elliott WM，et al. Decreased histone deacetylase activity in chronic obstructive pulmonary disease [J]. N Engl J Med，2005，325（19）：1967-1976.
[20] Dahl M. Biomarkers for chronic obstructive pulmonary disease：surfactant protein D and C-reactive protein [J]. Am J Respir Crit Care Med，2008，177（11）：1177-1178.
[21] 李晓明，汪丽珠，龚国富.慢性阻塞性肺疾病患者急性加重期D-二聚体与APACHEⅡ评分的相关性分析[J].临床肺科杂志，2015（11）：2109-20111.
[22] Barnes P，Ito K，Adobe IM. A mechanism of corticostrome resistance in COPD：inactivation of historic design [J]. Lancet，2004，363（9410）：731-733.
[23] Qu Y，Yang Y，Ma D，et al. Expression level of histone deacety lase2 correlates with occurring of chrionic obstructive pulmonary disease [J]. Mol Biol Rep，2013，40（6）：3995-4000.
[24] Lomas DA，Silverman EK，Edwards LD，et al. Serum surfactant protein D is steroid sensitive and associated with exacerbations of COPD [J]. Eur Respir J，2009，34：95-102.