COPD合并呼吸衰竭患者外周血bFGF、CHE水平变化的意义

Significance of changes of peripheral blood bFGF and CHE levels in COPD patients with respiratory failure

目的探讨慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者外周血碱性成纤维细胞生长因子(bFGF)、胆碱酯酶(CHE)水平变化的意义。方法回顾性选取2020年4月至2021年5月在本院接受检查与治疗的180例COPD患者及80例正常体检者作为研究对象。依据是否发生呼吸衰竭将180例COPD患者分为COPD合并呼吸衰竭组(以下简称“合并组”,94例)及单纯COPD组(以下简称“单纯组”,86例),同时将正常体检者定为对照组(80例)。比较三组的血气分析指标、血清检测指标、急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分。同时根据疾病不同分期将COPD患者分为稳定组(76例)和急性加重组(104例);再根据疾病不同预后将COPD合并呼吸衰竭患者分为生存组(74例)和死亡组(20例)。分别比较不同分组标准下各组的血气分析指标、血清检测指标及APACHEⅡ评分。分析外周血血清检测指标与APACHEⅡ评分的相关性。结果三组的动脉血氧分压(PaO_(2))、CHE水平比较结果为合并组<单纯组<对照组,差异具有统计学意义(P<0.05);三组的动脉血二氧化碳分压(PaCO_(2))、bFGF水平比较结果为合并组>单纯组>对照组,差异具有统计学意义(P<0.05);合并组的APACHEⅡ评分显著高于单纯组,差异具有统计学意义(P<0.05)。稳定组的PaO_(2)、CHE水平显著高于急性加重组,差异具有统计学意义(P<0.05);稳定组的PaCO_(2)、bFGF水平及APACHEⅡ评分显著低于急性加重组,差异具有统计学意义(P<0.05)。生存组的PaO_(2)、CHE水平显著高于死亡组,PaCO_(2)、bFGF水平及APACHEⅡ评分显著低于死亡组,差异具有统计学意义(P<0.05)。CHE水平与APACHEⅡ评分呈负相关(r=-0.806,P<0.05),而bFGF水平与APACHEⅡ评分呈正相关(r=0.749,P<0.05)。结论外周血bFGF与CHE水平变化与COPD合并呼吸衰竭患者疾病发生、发展、预后及病情严重程度存在密切关系,可作为COPD合并呼吸衰竭病情评估的客观指标。

Objective To investigate the significance of changes of peripheral blood basic fibroblast growth factor(bFGF)and cholinesterase(CHE)levels in chronic obstructive pulmonary disease(COPD)patients with respiratory failure.Methods A total of 180 COPD patients and 80 normal physical examination subjects who received examination and treatment in our hospital from April 2020 to May 2021 were retrospectively selected.A total of 180 COPD patients were divided into COPD combined with respiratory failure group(here in after referred to as the"combined group",94 cases)and COPD alone group(here in after referred to as the"simple group",86 cases)according to whether the patients had respiratory failure;at the same time,the subjects who underwent normal physical examination were selected as control group(80 cases).Blood gas analysis indexes,serum detection indexes and Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score were compared among the three groups.At the same time,according to different stages of the disease,COPD patients were divided into stable group(76 cases)and acute exacerbation group(104 cases);according to the different prognosis of the disease,COPD patients with respiratory failure were divided into survival group(74 cases)and death group(20 cases).Blood gas analysis indexes,serum detection indexes and APACHEⅡ score of each group under different grouping criteria were compared.The correlation between peripheral blood serum detection indexes and APACHEⅡ score was analyzed.Results The comparison results of arterial partial pressure of oxygen(PaO_(2))and CHE level among the three groups were the combined group<the simple group<the control group,and the differences were statistically significant(P<0.05);the comparison results of arterial partial pressure of carbon dioxide(PaCO_(2))and bFGF level among the three groups were the combined group>the simple group>the control group,and the differences were statistically significant(P<0.05);the APACHEⅡ score of the combined group was significantly higher than that of the simple group,and the difference was statistically significant(P<0.05).The PaO_(2) and CHE level in the stable group were significantly higher than those in the acute exacerbation group,and the differences were statistically significant(P<0.05);the PaCO_(2),bFGF level and APACHEⅡ score in the stable group were significantly lower than those in the acute exacerbation group,and the differences were statistically significant(P<0.05).The PaO_(2) and CHE level in the survival group were significantly higher than those in the death group,the PaCO_(2),bFGF level and APACHEⅡ score were significantly lower than those in the death group,and the differences were statistically significant(P<0.05).CHE level was negatively correlated with APACHEⅡ score(r=-0.806,P<0.05),while bFGF level was positively correlated with APACHEⅡ score(r=0.749,P<0.05).Conclusion The changes of bFGF and CHE levels in peripheral blood are closely related to the occurrence,development,prognosis and severity of COPD patients with respiratory failure,which can be used as objective indicators for the evaluation of COPD patients with respiratory failure.