COPD合并呼吸衰竭患者血清HEPCIDIN表达及与预后评估关系

Relationship between Serum HEPCIDIN Expression and Prognosis in Patients with COPD Complicated with Respiratory Failure

目的:探讨COPD合并呼吸衰竭患者血清HEPCIDIN表达及与预后评估。方法:本院COPD合并呼吸衰竭患者115例为病例组,我院门诊健康体检者52例作为对照组,测定各组CRP、WBC、HEPCIDIN、FEV1%、FEV1/FVC、DLCO%水平,同时测定不同程度低氧血症COPD合并呼吸衰竭患者的HEPCIDIN水平。结果:病例组CRP、WBC、HEPCIDIN、IL-6水平高于对照组(P<0.05);病例组HbA1c、FEV1%、FEV1/FVC、DLCO%均低于对照组(P<0.05);随着低氧血症严重程度的增加,HEPCIDIN水平逐渐增加(P<0.01);HEPCIDIN与HbA1c、FEV1%、FEV1/FVC、DLCO%负相关关系明显,与CRP、WBC、IL-6正相关关系明显(P<0.05);高水平的HEPCIDIN、IL-6以及低水平的HbA1c、FEV1/FVC均为COPD合并呼吸衰竭发生死亡事件的危险因素(P<0.05);HEPCIDIN、HbA1c两者的AUC相近,皆小于FEV1/FVC;HEPCIDIN、HbA1c诊断COPD合并呼吸衰竭的灵敏度、特异度相近(χ^2=1.219、1.695,P>0.05),皆小于FEV1/FVC(χ^2=16.249、17.023,P<0.05)。结论:COPD合并呼吸衰竭患者血清HEPCIDIN水平升高,且与COPD疾病严重程度密切相关;高水平的HEPCIDIN、IL-6以及低水平的HbA1c、FEV1/FVC均为COPD合并呼吸衰竭发生死亡事件的危险因素;HEPCIDIN诊断COPD合并呼吸衰竭具有较高的灵敏度、特异度,值得在临床上推广应用。

Objective:To investigate the relationship between serum HEPCIDIN expression and prognosis in patients with COPD complicated with respiratory failure.Methods:115 cases of COPD complicated with respiratory failure(case group)and 52 cases of health examinees(control group)in our hospital were selected.The levels of CRP,WBC,HEPCIDIN,FEV1%,FEV1/FVC,and DLCO%were measured;moreover,the HEPCIDIN levels of patients with different degrees of hypoxemia were also measured.Results:The case group had higher levels of CRP,WBC,HEPCIDIN and IL-6 than those of the control group(P<0.05).HbA1c,FEV1%,FEV1/FVC and DLCO%in the case group were lower than the control group(P<0.05).The HEPCIDIN level was positively correlated with the degrees of hypoxemia(P<0.01).HEPCIDIN was negatively correlated with HbA1c,FEV1%,FEV1/FVC,and DLCO%,and positively correlated with CRP,WBC and IL-6(P<0.05).High levels of HEPCIDIN,IL-6 and low levels of HbA1c,FEV1/FVC were risk factors for death of COPD with respiratory failure(P<0.05).The AUC,sensitivity and specificity of HEPCIDIN and HbA1c were similar(χ^2=1.219,1.695,P>0.05),which were lower than those of the FEV1/FVC(χ^2=16.249,17.023,P<0.05).Conclusion:Elevated serum HEPCIDIN levels are closely related to the severity of COPD disease;furthermore,high levels of HEPCIDIN,IL-6 and low levels of HbA1c,FEV1/FVC are risk factors for the death of COPD and respiratory failure;As a predictor,the sensitivity and specificity of HEPCIDIN in diagnosis of COPD with respiratory failure are high and is worthy of clinical application.