VEGF与COPD急性加重期并发呼吸衰竭患者预后的相关性研究

The correlation between VEGF and prognosis of patients with COPD in acute exacerbation period complicated with respiratory failure

目的:探究VEGF与COPD急性加重期并发呼吸衰竭患者预后的相关性。方法:选取2014年3月至2015年6月来我院就诊的COPD急性加重期并发呼吸衰竭的患者70例为研究对象,将在随访期存活的52例患者作为存活组,死亡的18例患者作为死亡组。患者入院后24 h内收集完基本资料,均给予经验性广谱抗生素、吸氧和化痰剂、支气管扩张剂以及有效的无创或有创通气,若情况得不到有效控制,必要时转入ICU进行治疗。测定血清VEGF水平、hs-CRP含量、FIB、PCT、WBC,FEV1/Pred%、FEV1/FVC%、Pa CO2、Pa O2/Fi O2,并进行APACHEⅢ评分。结果:两组患者在性别、BMI方面没有差异,但在年龄、病程和吸烟指数方面存在明显的差异,且具有统计学意义(P<0.05)。死亡组患者的VEGF、hs-CRP、PCT、FEV1/Pred%、FEV1/FVC%和Pa O2/Fi O2均明显低于存活组,WBC、Pa CO2和APACHEⅢ明显高于存活组,差异具有统计学意义(P<0.05),FIB在两组之间差异无统计学意义(P>0.05)。血清VEGF与BMI、病程、FEV1/Pred%、FEV1/FVC%及APACHEⅢ评分呈正相关,与Pa CO2呈负相关,差异具有统计学意义(P<0.05),与年龄、病程、吸烟指数、氧合指数、hs-CRP和PCT不具有直线相关性。结论:血清VEGF作为检测COPD急性加重期并发呼吸衰竭患者炎症程度的相关因子之一,可成为评估患者病情预后的重要血清生物学标志物。

Objective： To explore the correlation between VEGF and prognosis of patients with COPD in acute exacerbation period complicated with respiratory failure. Methods： From March 2014 to June 2015,70 patients with acute exacerbation of COPD complicated with respiratory failure in our hospital were selected as study subjects.Among them there were 52 patients who survived the follow-up period as survival group,18 patients died as death group. All patients admitted to the hospital, then the empirical broad- spectrum antibiotics, oxygen and expectorant,bronchodilators and effective noninvasive or with invasive ventilation were given,if symptoms could not be effectively controlled,the patients were carried into ICU. The levels of serum hs-CRP,VEGF,FIB,PCT,WBC,FEV1 / Pred%,FEV1 / FVC%,Pa CO2,Pa O2/ Fi O2,and APACHEⅢ were measured. Results： There were no differences in gender and BMI between the two groups,but there were statistical differences in age,duration of disease and smoking index（ P〈0. 05）. The VEGF,hs-CRP,PCT,FEV1 / Pred%,FEV1 / FVC% and Pa O2/Fi O2 of patients in the death group were significantly lower than those in the survival group,WBC,Pa CO2 and APACHEⅢ were significantly higher than those of survival group,the differences had statistical significances（ P〈0. 05）,the difference of FIB between the two groups had no statistical significance（ P〉0. 05）. Serum levels of VEGF were positively correlated with BMI,duration of disease,FEV1 / Pred%,FEV1 / FVC% and APACHE Ⅲscore,VEGF level was negatively correlated with Pa CO2,the differences were statistically significant（ P〈0. 05）,and VEGF level with age,duration of disease,smoking index,oxygenation index,hs-CRP,PCT didn＇t have linear correlation. Conclusion： The serum VEGF can be used as one of the related factors in the detection of the degree of inflammation of patients with acute exacerbation of COPD complicated with respiratory failure,and it can be one of the biological markers for judging the prognosis of patients.