和肽素检测在呼吸衰竭患者中的应用价值研究

Application value of the detection of copeptin in patients with respiratory failure

目的通过对呼吸衰竭患者和肽素水平的检测,评估其在呼吸衰竭患者病情发展中的应用价值。方法选取120例呼吸衰竭患者,采用酶联免疫吸附法测定和肽素水平,对比急性期及缓解期(加重期)各指标的变化,分析和肽素在呼吸衰竭患者疾病转归中的变化。结果生存组患者入院时和肽素、二氧化碳分压、乳酸、BNP、CRP水平均高于缓解期,差异有统计学意义(P<0.05)。入院急查和肽素、氧分压、二氧化碳分压、乳酸、BNP、CRP水平,死亡组和肽素、乳酸、CRP水平高于生存组(P<0.05)。吸烟、是否长期家庭氧疗、是否规律吸入激素治疗与呼吸衰竭患者入院时和肽素检测结果比较,差异无统计学意义(P>0.05)。Logistic回归分析显示,肽素、乳酸与呼吸衰竭患者疾病严重程度有相关性(和肽素:P<0.05,OR=0.013,95%CI 0.007~1.030;乳酸:P<0.05,OR=0.034,95%CI 0.007~1.241)。结论呼吸衰竭患者急性期水平和肽素水平较缓解期明显升高,血清乳酸和和肽素与呼吸衰竭患者的疾病严重程度相关,对呼吸衰竭患者住院期间检测和肽素水平,可以获取更多诊疗信息。

Objective To detect the level of copeptin and evaluate the value in the development of patients with respiratory failure.Methods 120 patients with respiratory failure were selected.The levels of copeptin were detected by ELISA.The changes of indexes in acute phase and remission phase(aggravation phase)were compared,and the changes of copeptin in the prognosis of patients with respiratory failure were analyzed.Results The levels of PCO_(2),Lac,BNP,CRP and copeptin in the patients of the survival group at admission were significantly higher than those in the remission period(P<0.05).Comparing with death groups,the levels of Lac,copeptin,CRP were significantly higher than those in the survival group(P<0.05).There were no significant difference among smoking,oxygen therapy,regular inhaled hormone therapy and the level of copeptin in patients with respiratory failure at admission(P>0.05).Logistic regression analysis showed that copeptide and lactic acid were related to the severity of respiratory disease of the patients with respiratory failure(copeptin:P<0.05,OR=0.013,95%CI:0.007~1.030),Lac:P<0.05,OR=0.034,95%CI:0.007~1.241).Conclusion The level of copeptin can reflect the severity of patients with respiratory failure and has certain clinical value to evaluate the quality of life in the patients.