老年慢性阻塞性肺疾病伴低氧血症血清相关指标与认知功能损伤的关系

Relationship Between Related SerumIndexes and Cognitive Impairment in Elderly Patients with Chronic Obstructive Pulmonary Disease Complicated by Hypoxemia

目的探究老年慢性阻塞性肺疾病(COPD)伴低氧血症患者血清可溶性髓系细胞表达触发受体-1(sTREM-1)、单核细胞趋化蛋白-1(MCP-1)、内皮素-1(ET-1)水平与认知功能受损的关系。方法112例老年COPD患者按血气分析结果分为低氧血症组、非低氧血症组,选取50例健康正常老年人作为对照组,测定sTREM-1、MCP-1、ET-1水平;比较三组患者血清上述指标的差异,分析以上指标与蒙特利尔认知评估量表(MoCA)评分的关系,以及这些指标预测认知障碍发生的价值。结果低氧血症组、非低氧血症组sTREM-1、MCP-1、ET-1高于对照组,MoCA表评分低于对照组(P<0.05),低氧血症组sTREM-1、MCP-1、ET-1高于非低氧血症组,MoCA表评分低于非低氧血症组(P<0.05);COPD伴低氧血症认知障碍组的血清sTREM-1、MCP-1、ET-1高于认知正常组(P<0.05);sTREM-1预测COPD伴低氧血症患者认知障碍发生敏感度、特异性分别为75.00%、90.48%;ET-1预测敏感度、特异性分别为78.57%、66.67%;COPD伴低氧血症患者sTREM-1、MCP-1、ET-1与MoCA评分呈负相关(P<0.05)。结论老年COPD伴低氧血症患者血清sTREM-1、MCP-1、ET-1处于较高水平,且与认知损伤程度有关;sTREM-1、ET-1对认知损伤预测价值较高。

Objective To explore the relationship between serum soluble triggering receptor expressed on myeloid cells1(sTREM-1),monocyte chemoattractant protein-1(MCP-1),endothelin-1(ET-1)levels and cognitive impairment in elderly patients with chronic obstructive pulmonary disease(COPD)and hypoxemia.Methods 112 elderly patients with COPD were selected and divided into hypoxemia group and non-hypoxemia group according to the blood gas analysis results.Meanwhile,50 healthy elderly people were enrolled as control group.The levels of sTREM-1,MCP-1 and ET-1 were measured.Levels of the above serum factors were compared among patients with different cognitive function.The correlation between above indexes and Montreal Cognitive Assessment(MoCA)scores,and their value in predicting occurrence of cognitive impairment were analyzed.Results The levels of sTREM-1,MCP-1 and ET-1 in hypoxemia group and non-hypoxemia group were higher than those in control group,while MoCA scores were lower than those of control group(P<0.05).The levels of sTREM-1,MCP-1 and ET-1 in hypoxemia group were higher than those in non-hypoxemia group,while MoCA scores were lower than those of non-hypoxemia group(P<0.05).The levels of serumsTREM-1,MCP-1 and ET-1 in cognitive impairment group were higher than those in normal cognition group(P<0.05).The sensitivity and specificity of sTREM-1 in predicting cognitive impairment in patients with COPD and hypoxemia were 75.00%and 90.48%,which of ET-1 were 78.57%and 66.67%,respectively.Serum sTREM-1,MCP-1 and ET-1 were negatively correlated with MoCA scores of patients with COPD and hypoxemia(P<0.05).Conclusion The levels of serumsTREM-1,MCP-1 and ET-1 are higher in elderly patients with COPD and hypoxemia,and they are related to the degree of cognitive impairment.The predictive value of sTREM-1 and ET-1 is higher for cognitive impairment.