血管内皮生长因子在慢性阻塞性肺疾病急性加重期诊断中的应用及预后评估价值

The Value of Vascular Endothelial Growth Factor for the Diagnosis and Prognostic Evaluation in acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的探讨血管内皮生长因子在慢性阻塞性肺疾病(COPD)急性加重期诊断中的应用及预后的评估价值。方法选取2012年3月—2013年3月我院收治的慢性阻塞性肺疾病稳定期患者15例为稳定组,急性加重期患者30例(脓痰组15例和非脓痰组15例)为加重组,选取同期15例健康者为对照组,在入院24小时内检测各组的血管内皮生长因子(VEGF)、超敏C-反应蛋白(hs-CRP)、白细胞(WBC)、血清降钙素原(PCT),记录第8天加重组以上指标变化情况,记录加重组患者入院24小时内及治疗第8天急性生理与慢性生理健康状况评分系统Ⅲ(APACHEIII)评分。结果加重组24小时内VEGF水平显著高于稳定组,而稳定组又显著高于对照组,差异具有统计学意义(P<0.05);VEGF的敏感度为86.7%,特异度60%,脓痰组24小时内VEGF水平显著高于非脓痰组,两组比较差异具有统计学意义(P<0.05);加重组VEGF水平和APACHEIII评分具有正相关关系。结论 VEGF是COPD急性加重期的一个敏感指标,可以反映病情的预后。

Objective To study the the value of vascular endothelial growth factor for the diagnosis and prognostic evaluation in acute exacerbation of chronic obstructive pulmonary disease.Methods 15 cases of patients with stable chronic obstructive pulmonary disease during stable phase from March 2012 to March 2013 in our hospital were selected as the stabilization group,30 cases with acute exacerbation （15 cases of thick phlegm group and 15 cases of non phlegm group）were selected as the exacerbation group,15 cases of healthy people were selected as the control group,vascular endothelial growth factor （VEGF）,high sensitive C-reactive protein （hs-CRP）,white blood cell（WBC）,serum procalcitonin （PCT）of the exacerbation group,stabilization group and the control group were measured in 24 hours after admission,and recorded the above index of the exacerbation group at 8th day and its acute physiology and chronic health evaluation Ⅲ （APACHEⅢ ）within 24 hours and 8th day of treatment.Results VEGF in the exacerbation group was significantly higher than that in the stabilization group within twenty-fourth hours,and the stabilization group was significantly higher than that in control group,the difference was significant （P 〈0.05）;The sensitivity of VEGF index was 86.7%,the specificity was 60%,VEGF in the thick phlegm group was significantly higher than that in the non phlegm group within twenty-fourth hours,there was statistically significant difference between the two groups （P 〈0.05）;VEGF level and APACHEIII score of the exacerbation group had a positive correlation.Conclusion Vascular endothelial growth factor is a sensitive indicator for acute exacerbation of chronic obstructive pulmonary disease,it can reflect the severity of the disease and its prognosis.