血清α1-抗胰蛋白酶、血管紧张素-Ⅱ与获得性免疫缺陷综合征患者预后的关系

Relationship between serumα1-antitrypsin,angiotensin-Ⅱand prognosis of AIDS patients

目的探讨血清α1-抗胰蛋白酶(α1-AT)、血管紧张素-Ⅱ(Ang-Ⅱ)与获得性免疫缺陷综合征(AIDS)患者预后的关系。方法将该院2019年5月至2022年5月收治的97例首诊AIDS患者纳入研究作为研究组,另选取同期于该院进行体检的健康者97例作为对照组。根据病历收集患者临床资料。对纳入研究者进行α1-AT、Ang-Ⅱ水平检测,并进行分组比较。对纳入研究的AIDS患者进行为期1年的随访,观察患者预后情况,并比较不同预后患者的α1-AT、Ang-Ⅱ水平。采用单因素及多因素Logistic回归分析影响AIDS患者预后的因素。用受试者工作特征(ROC)曲线分析α1-AT、Ang-Ⅱ水平对患者预后的预测效能。结果研究组血清α1-AT和Ang-Ⅱ水平高于对照组(P<0.05)。AIDS患者1年内的预后不良发生率为23.71%(23/97)。预后不良患者血清α1-AT和Ang-Ⅱ水平高于预后良好患者(P<0.05)。单因素分析显示,预后不良患者C反应蛋白(CRP)水平、淋巴细胞计数水平、合并淋巴瘤者所占比例均高于预后良好患者,清蛋白(ALB)水平低于预后良好患者(P<0.05)。多因素Logistic回归分析显示,合并淋巴瘤(OR=2.087)、高α1-AT水平(OR=2.611)、高Ang-Ⅱ水平(OR=2.138)是影响患者预后的独立危险因素(P<0.05)。ROC曲线分析显示,α1-AT预测AIDS患者预后的曲线下面积(AUC)为0.778,Ang-Ⅱ预测的AUC为0.798,α1-AT联合Ang-Ⅱ预测的AUC为0.918。结论α1-AT和Ang-Ⅱ在AIDS患者血清中水平异常升高,而且与患者预后有关,是影响患者预后的独立危险因素。α1-AT和Ang-Ⅱ联合检测可有效预测患者预后。

Objective To investigate the relationship between serumα1-antitrypsin(α1-AT),angiotensin-Ⅱ(Ang-Ⅱ)and the prognosis of patients with acquired immunodeficiency syndrome(AIDS).Methods A total of 97 first-diagnosed AIDS patients admitted to the hospital from May 2019 to May 2022 were enrolled in the study as the study group,and 97 healthy people who underwent physical examination in the hospital during the same period were enrolled as the control group.The clinical data of patients were collected according to the medical records.The levels ofα1-AT and Ang-Ⅱwere detected and compared between groups.AIDS patients enrolled in the study were followed up for 1 year to observe the prognosis of the patients,and theα1-AT and Ang-Ⅱlevels of patients with different prognosis were compared.Univariate and multivariate Logistic analysis were used to analyze the factors affecting the prognosis of AIDS patients.Receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy ofα1-AT and Ang-Ⅱlevels for the prognosis of patients.Results The levels of serumα1-AT and Ang-Ⅱin the study group were higher than those in the control group(P<0.05).The incidence of poor prognosis in AIDS patients within one year was 23.71%(23/97).The levels of serumα1-AT and Ang-Ⅱin patients with poor prognosis were higher than those in patients with good prognosis(P<0.05).Univariate analysis showed that the level of C-reactive protein(CRP),lymphocyte count and the proportion of patients with lymphoma in patients with poor prognosis were higher than those in patients with good prognosis,and the level of albumin(ALB)was lower than that in patients with good prognosis(P<0.05).Multivariate Logistic regression analysis showed that lymphoma(OR=2.087),highα1-AT level(OR=2.611)and high Ang-Ⅱlevel(OR=2.138)were independent risk factors affecting the prognosis of patients(P<0.05).ROC curve analysis showed that the area under the curve(AUC)ofα1-AT predicting the prognosis of AIDS patients was 0.778,the AUC of Ang-Ⅱpredicting was 0.798,and the AUC ofα1-AT combined with Ang-Ⅱpredicting was 0.918.Conclusion The serum levels ofα1-AT and Ang-Ⅱin AIDS patients are abnormally increased,and are related to the prognosis of patients,which are independent risk factors for the prognosis of patients.The combined detection ofα1-AT and Ang-Ⅱcan effectively predict the prognosis of patients.