老年COPD合并呼衰患者血清CysC、VEGF、ACTA水平与病情严重程度的相关性

目的分析老年慢性阻塞性肺疾病(chronic obstructive pulmonary diseases, COPD)合并呼吸衰竭(respiratory failure, RF)患者血清胱氨酸蛋白酶抑制剂C(cystatin protease inhibitor C, CysC)、血管内皮生长因子(vascular endothelial growth factor, VEGF)、激活素A(activin A, ACTA)水平与病情严重程度的相关性。 方法选择四川大学华西医院住院治疗的106例老年COPD合并RF患者为RF组，按动脉血氧分压(PaO₂)将患者分为轻度组36例、中度组41例和重度组29例，另选取医院相同时间段收治的47例单纯COPD患者为非RF组，比较各组患者血清CysC、VEGF、ACTA水平及一秒钟用力呼气容积占预计值百分比(FEV₁)、一秒钟用力呼气容积占用力肺活量百分比(FEV₁/FVC)差异，并分析血清CysC、VEGF、ACTA水平与FEV1%、FEV₁/FVC相关性。 结果RF组患者血清CysC、ACTA水平高于非RF组(P<0.05)，VEGF水平、FEV1%、FEV₁/FVC低于非RF组(P<0.05)；老年COPD合并RF患者病情越严重，血清CysC、ACTA水平越高，VEGF水平、FEV1%、FEV₁/FVC越低，轻度组、中度组和重度组患者组间存在显著差异(P<0.05)；Pearson相关检验结果显示，老年COPD合并RF患者血清CysC与FEV1%、FEV₁/FVC均呈负相关(r＝-0.530，P<0.01；r＝-0.594，P<0.01)；VEGF与FEV1%、FEV₁/FVC均呈正相关(r＝0.571，P<0.01；r＝0.668，P<0.01)；ACTA与FEV1%、FEV₁/FVC均呈负相关(r＝-0.604，P<0.01；r＝-0.557，P<0.01)。 结论老年COPD合并RF患者血清CysC、VEGF、ACTA水平与其病情严重程度存在密切相关性，有助于对患者及时作出病情评估。

Correlation between levels of serum CysC,VEGF, and ACTA and disease severity in elderly patients with COPD and respiratory failure

ObjectiveTo analyze the correlation between levels of serum Cystatin C (CysC), vascular endothelial growth factor (VEGF) and activin A (ACTA) and disease severity in elderly patients with chronic obstructive pulmonary disease (COPD) complicated with respiratory failure (RF). MethodsA total of 106 elderly patients with COPD and RF who were treated in West China Hospital, Sichuan University were selected as RF group. The patients were divided into mild group (36 cases), moderate group (41 cases) and severe group (29 cases) according to the partial pressure of blood oxygen (PaO₂). Another 47 patients with simple COPD admitted to the hospital during the same time period were selected as non-RF group. The levels of serum CysC, VEGF, and ACTA and the percentage of forced expiratory volume in one second and predicted value (FEV₁) and percentage of forced expiratory volume in one second and forced vital capacity (FEV₁/FVC) were compared in each group, and the correlation between levels of serum CysC, VEGF and ACTA and FEV1% and FEV₁/FVC were analyzed. ResultsThe levels of serum CysC and ACTA in RF group were higher than those in non-RF group (P<0.05) while the VEGF level, FEV1% and FEV₁/FVC were lower than those in non-RF group (P<0.05). The more severe the elderly COPD patients with RF, the higher the serum CysC and ACTA levels and the lower the VEGF level, FEV1% and FEV₁/FVC. And there were significant differences between mild group, moderate group and severe group (P<0.05). Pearson correlation test results showed that the serum CysC in elderly patients with COPD and RF was significantly negatively correlated with FEV1%, and FEV₁/FVC (r=-0.530, P<0.01, r=-0.594, P<0.01). VEGF was significantly positively correlated with FEV1%, and FEV₁/FVC (r=0.571, P<0.01, r=0.668, P<0.01). ACTA was significantly negatively correlated with FEV1% and FEV₁/FVC (r=-0.604, P<0.01, r=-0.557, P<0.01). ConclusionSerum CysC, VEGF, and ACTA levels in elderly patients with COPD and RF are closely related to the disease severity, and they are helpful for timely disease assessment in patients.