|
|
|
| Influencing factors of the prognosis of COPD complicated with type Ⅱ respiratory failure and the value of serum UA, cTnT, and NT-proBNP levels in predicting the prognosis#br# |
| CAO Yi JIA Zhenyu |
| Department of General Medicine, Zhangjiagang Hospital Affiliated to Soochow University, Jiangsu Province, Zhangjiagang 215600, China |
|
|
|
Abstract Objective To explore the influencing factors of the prognosis of chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure and the value of serum uric acid (UA), cardiac troponin T (cTnT), and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in prediciting the prognosis. Methods The clinical data of 100 patients with COPD and type Ⅱ respiratory failure admitted to Zhangjiagang Hospital Affiliated to Soochow University from February 2018 to June 2020 were retrospectively analyzed. Patients were divided into good prognosis group (76 cases) and poor prognosis group (24 cases) according to the prognosis. The prognostic factors of COPD patients with type Ⅱ respiratory failure were analyzed, and the predictive value of serum UA, cTnT, and NT-probNP levels for the prognosis of patients were analyzed. Results In the poor prognosis group, 15 patients developed myocardial infarction, three patients developed heart failure, two patients developed multiple organ dysfunction, two patients developed angina pectoris, and two patients died. The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, UA, cTnT, NT-probNP, D-dimer, and C-reactive protein levels in the poor prognosis group were higher than those in the good prognosis group, and the differences were statistically significant (P ＜ 0.05). Multivariate analysis showed that high APACHE Ⅱ score, and high serum UA, cTnT, and NT-probNP levels were independent risk factors for poor prognosis in COPD patients with type Ⅱ respiratory failure (OR ＞ 1, P ＜ 0.05). The receiver operating characteristic curve of subjects showed that serum UA, cTnT, NT-probNP, and their combination had certain diagnostic value for the prognosis of COPD patients with type Ⅱ respiratory failure (area under the curve＞0.5, P ＜ 0.05). Conclusion Serum UA, cTnT, and NT-probNP in COPD patients with type Ⅱ respiratory failure are correlated with prognosis, and the three have certain diagnostic value of prognosis alone or in combination.
|
|
|
|
|
|
[1] 易方莲，易松涛.慢性阻塞性肺疾病流行病学调查和防控措施研究[J].解放军预防医学杂志，2018，36（2）：171-173.
[2] Corlateanu A，Mendez Y，Wang Y，et al. Chronic obstructive pulmonary disease and phenotypes：a state-of-the-art [J]. Pulmonology，2020，26（2）：95-100.
[3] 刘康珍，覃智芳.慢性阻塞性肺疾病合并肺部感染患者血清炎症因子、尿酸、NT-proBNP水平与肺功能的相关性研究[J].现代医学，2019，47（6）：692-696.
[4] 冯思玮，马万里，熊亮.血尿酸在慢性阻塞性肺疾病患者中临床意义的Meta分析[J].中国临床研究，2020，33（1）：41-46.
[5] Welsh P，Preiss D，Hayward C，et al. Cardiac Troponin T and Troponin I in the General Population [J]. Circulation，2019，139（24）：2754-2764.
[6] 王晓燕，朱磊，穆东，等.不稳定性心绞痛患者检测高敏肌钙蛋白T的临床意义[J].中华老年心脑血管病杂志，2019，21（2）：86-88.
[7] 冯晓丽，黄娜，李培培，等.无创序贯机械通气对重症肺炎合并呼吸衰竭患者血浆ANP、NT-proBNP的影响[J].西部医学，2018，30（5）：724-727.
[8] 中华医学会，中华医学会杂志社，中华医学会全科医学分会，等.慢性阻塞性肺疾病基层诊疗指南（2018年）[J].中华全科医师杂志，2018，17（11）：856-870.
[9] Lamba TS，Sharara RS，Singh AC，et al. Pathophysiology and classification of Respiratory Failure [J]. Crit Care Nurs Q，2016，39（2）：85-93.
[10] Niewinski G，Starczewska M，Kanski A. Prognostic scoring systems for mortality in intensive care units——the APACHE model[J]. Anaesthesiol Intensive Ther，2014，46（1）：46-49.
[11] 慢性阻塞性肺疾病急性加重抗感染治疗中国专家共识编写组.慢性阻塞性肺疾病急性加重抗感染治疗中国专家共识[J].国际呼吸杂志，2018，39（17）：1281-1296.
[12] Andre S，Conde B，Fragoso E，et al. COPD and cardiovascular disease [J]. Pulmonology，2019，25（3）：168-176.
[13] Cho WK，Lee CG，Kim LK. COPD as a disease of Immunosenescence [J]. Yonsei Med J，2019，60（5）：407-413.
[14] Bonnevie T，Elkins M. Chronic obstructive pulmonary disease [J]. J Physiother，2020，66（1）：3-4.
[15] 柯佳，田发念，郑岚，等.健脾益肺法治疗慢性阻塞性肺疾病稳定期的效果[J].中国医药导报，2019，16（24）：143-145.
[16] 黄艾丝，詹少锋，张天鸽，等.刘小虹教授辨治慢性阻塞性肺疾病的临床经验介绍[J].中国医药导报，2019，16（27）：151-154.
[17] 李雅超，杨彦立，安蕾，等. 不同性别血尿酸水平与冠心病及冠状动脉狭窄程度的关系[J].中国医药导报，2020， 17（11）：134-137.
[18] Mishima E，Anzai N，Miyazaki M，et al. Uric Acid Elevation by Favipiravir，an Antiviral Drug [J]. Tohoku J Exp Med，2020，251（2）：87-90.
[19] Jung SW，Kim SM，Kim YG，et al. Uric acid and inflammation in kidney disease [J]. Am J Physiol Renal Physiol，2020，318（6）：1327-1340.
[20] 马爱闻，徐继扬，陈俊，等.N末端B型钠尿肽原及心肌肌钙蛋白Ⅰ对慢性阻塞性肺疾病合并肺动脉高压患者病情的评估价值[J].实用临床医药杂志，2020，24（7）：21-24.
[21] 杨镋灵.NT-ProBNP、CRP水平变化对AE COPD的诊断价值及其临床意义研究[J].湖南师范大学学报：医学版，2018，15（4）：145-147.
[22] 金午仙，叶丹，王学静.血浆NT-pro BNP和hs-CRP在COPD合并呼吸衰竭中的临床价值[J].河北医药，2019， 41（11）：1696-1698.
[23] 易福凌，李宁，李永刚，等.cTnT、NT-proBNP与慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭预后的关系研究[J].检验医学与临床，2020，17（15）：2146-2149.
[24] 李雪翔，程景林，戚金威，等.cTnT，NT-proBNP，Lac及APACHEⅡ评分与AECOPD伴呼吸衰竭患者预后的相关性分析[J]. 浙江医学，2017，15（354）：68-70.
[25] 王彦宏，郝东侠.老年慢性阻塞性肺疾病合并呼吸衰竭病人预后影响因素分析[J].实用老年医学，2018，32（10）：970-972. |
|
|
|
