血清合肽素、降钙素原对COPD急性加重患者临床风险预测的价值

Prognostic value of serumal copeptin and procalcitonin in patients with acute exacerbation of COPD

目的:评估血清合肽素、降钙素原对慢性阻塞性肺疾病急性加重(AECOPD)患者临床风险预测的价值。方法:选择159例住院治疗的AECOPD患者,在入组时、入组第14天、第6个月末分别留取血清标本,采用酶联免疫吸附法测定血清合肽素水平,电化学发光法测定降钙素原水平。采用单因素和多因素分析血清合肽素、降钙素原水平对AECOPD患者临床风险预测的价值。结果:与入组第14天和第6个月末相比,AECOPD患者入组时血清合肽素、降钙素原水平显著升高(均P<0.05)。在6个月随访过程中单因素分析显示:入组时血清合肽素水平较高的患者死亡率较高(P<0.05),而降钙素原水平较高的患者死亡率无明显升高(P>0.05);多因素分析显示:血清合肽素水平是AECOPD患者6个月内死亡事件发生的唯一预测因子(P<0.05);血清合肽素水平预测6个月内死亡事件的受试者工作特征曲线下面积为0.74(0.61～0.87,P<0.05)。结论:血清合肽素水平可以作为AECOPD患者临床风险预测指标。

Objective： To estimate the prognostic value of serumal copeptin and procalcitonin in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.Methods： We enrolled 159 hospitalized AECOPD patients.Venous blood samples were collected for measurement of serumal copeptin and procalcitonin at baseline,14 days and 6 months after including.The prognostic value of serumal copeptin and procalcitonin in patients with AECOPD were analyzed with univariate and multivariate analysis.Results： Comparing with the 14 days and 6 months after including,serumal levels of copeptin and procalcitonin were elevated at baseline（all P0.05）.Serumal copeptin levels were higher in patients with a death endpoint compared to survivors,but there was no difference of serumal procalcitonin level between the dead and survivors.In a multivariable Cox proportional hazards model only copeptin was predictive for mortality（P0.05）.For the prediction of death,receiver operating characteristic（ROC） curve analysis revealed an area under the curve for copeptin of 0.74（0.61-0.87,P0.05）.Conclusion： Serumal copeptin is a promising marker to predict the outcome in patients with AECOPD.