血Lac、hs-CRP/Alb比值联合HIF-1α水平对AECOPD患者预后的评估价值

Value of blood Lac and hs-CRP/Alb ratio combined with HIF-1αlevel in prognosis of patients with AECOPD

目的探究血乳酸(Lac)、高敏C反应蛋白(hs-CRP)/白蛋白(Alb)比值联合缺氧诱导因子-1(HIF-1α)水平,在评估慢性阻塞性肺疾病急性加重期(AECOPD)患者预后评估上的价值。方法选择我院2018年6月~2019年6月期间收治的116例AECOPD患者、98例稳定期COPD患者以及年龄性别匹配的80例健康者,分别作为AECOPD组、稳定期COPD组以及对照组。三组均测定血Lac、血清hs-CRP、Alb、HIF-1α水平,分析三指标水平在患者病情以及预后评估上的价值。结果Lac、hs-CRP/Alb比值、HIF-1α水平:AECOPD组>稳定期COPD组>对照组(P<0.05);随着AECOPD患者GOLD分级增加,患者血Lac、hs-CRP/Alb比值、HIF-1α水平逐渐增加(P<0.05);血Lac、hs-CRP/Alb比值、HIF-1α水平与患者病情严重程度呈正相关(r=0.825、0.419、0.687,P<0.05);预后良好组患者血Lac、hs-CRP/Alb比值、HIF-1α水平显著低于预后不佳组(P<0.05);ROC曲线显示,血Lac、hs-CRP/Alb比值分别联合HIF-1α、血Lac联合hs-CRP/Alb比值、三指标联合用于评估患者预后AUC值分别为0.980、0.947、0.993、0.997。结论血Lac、hs-CRP/Alb比值、HIF-1α可用于评估患者预后,其中三指标联合用于评估患者预后价值最佳。

Objective To explore the value of blood lactic acid(Lac)and high-sensitivity C-reactive protein(hs-CRP)/albumin(Alb)ratio combined with hypoxia-inducible factor-1(HIF-1α)level in prognosis assessment of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods From June 2018 to June 2019,116 patients with AECOPD(the AECOPD group),98 patients with stable COPD(the stable COPD group)and 80 healthy individuals(the control group)were enrolled in the study.The levels of blood Lac,serum hs-CRP,Alb and HIF-1αwere detected,and their value in condition and prognosis evaluation was evaluated.Results The Lac,hs-CRP/Alb ratio and HIF-1αlevel in the AECOPD group,the stable COPD group and the control group decreased in turn(P<0.05).With the increase of GOLD grade,blood Lac,hs-CRP/Alb ratio and HIF-1αlevel in patients with AECOPD increased(P<0.05).Blood Lac,hs-CRP/Alb ratio and HIF-1αlevel were positively correlated with the disease severity(r=0.825,0.419,0.687,P<0.05).The blood Lac,hs-CRP/Alb ratio and HIF-1αlevel in the good prognosis group were significantly lower than those in the poor prognosis group(P<0.05).ROC curve showed that AUC value of blood Lac and hs-CRP/Alb ratio respectively combined with HIF-1α,blood Lac combined with hs-CRP/Alb,and combination of the three for evaluating poor prognosis were 0.980,0.947,0.993 and 0.997,respectively.Conclusion Blood Lac,hs-CRP/Alb ratio and HIF-1αcan be applied to assess the prognosis of patients with AECOPD,especially the combination of the three indexes has the best evaluation value.