血清FIZZ2对AECOPD患者合并呼吸衰竭的诊断及预后评估分析

Diagnosis and prognosis assessment of serum FIZZ2 in patients with AECOPD complicated with respiratory failure

目的探讨血清发现于炎性反应区2(FIZZ2)对慢性阻塞性肺疾病急性加重期(AECOPD)患者合并呼吸衰竭(RF)的诊断及预后评估价值。方法选择2020年2月—2023年2月嘉峪关市第一人民医院急诊科收治的AECOPD合并RF患者186例作为RF组,将未发生RF的AECOPD患者186例作为非AF组。采用酶联免疫吸附法测定血清FIZZ2、降钙素原(PCT)、C反应蛋白(CRP)水平,根据AECOPD合并RF患者入组60 d存活情况分为死亡亚组(56例)和存活亚组(130例)。通过Pearson相关性分析FIZZ2与PCT、CRP的相关性,Logistic回归分析影响AECOPD合并RF患者预后的因素,绘制受试者工作特征(ROC)曲线分析FIZZ2预测AECOPD合并RF患者预后的价值。结果RF组血清FIZZ2、PCT、CRP水平高于非RF组(t/P=58.968/<0.001、16.260/<0.001、10.382/<0.001),死亡亚组血清FIZZ2、PCT、CRP水平高于存活亚组(t/P=5.164/<0.001、4.141/<0.001、12.354/<0.001)。Pearson相关性分析显示,AECOPD合并RF患者血清FIZZ2水平与PCT、CRP水平均呈正相关(r/P=0.452/<0.001、0.427/<0.001)。多因素Logistic回归分析显示,PCT、FIZZ2、APACHEⅡ评分升高是AECOPD合并RF患者预后不良的危险因素[OR(95%CI)=1.680(1.111~2.541)、1.921(1.147~3.217)、2.547(1.278~5.078)]。血清FIZZ2、PCT、CRP及三者联合预测AECOPD合并RF患者预后的AUC分别为0.842、0.794、0.846、0.925,三者联合优于各自单独预测(Z/P=3.465/0.001、2.399/0.016、2.194/0.028)。结论AECOPD合并RF患者血清FIZZ2水平升高,且与预后不良有关,在AECOPD合并RF患者预后预测中具有较高价值。

Objective To evaluate the diagnostic and prognostic value of serum found in inflammatory zone 2(FIZZ2)in acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with respiratory failure(RF).Methods One hundred and eighty-six cases of AECOPD patients with RF treated in the Emergency Department of Jiayuguan First People's Hospital from February 2020 to February 2023 were selected as the RF group and 186 cases of AECOPD patients without RF were selected as the non-AF group.Serum levels of FIZZ2,procalcitonin(PCT)and C-reactive protein(CRP)were determined by enzyme-related immunosorbent assay.Survival of patients with AECOPD combined with RF within 60 days was analyzed.According to survival,patients with AECOPD combined with RF were divided into death subgroup(56 cases)and survival subgroup(130 cases).Pearson correlation analysis was conducted to analyze the correlation between FIZZ2 and PCT and CRP.The factors affecting the prognosis of AECOPD patients with RF and the value of FIZZ2 in predicting the prognosis of AECOPD patients with RF were analyzed.Results The levels of serum FIZZ2,PCT and CRP in RF group were higher than those in non-RF group(t/P=58.968/<0.001,16.260/<0.001,10.382/<0.001).The levels of serum FIZZ2,PCT and CRP in death subgroup were higher than those in survival subgroup(t/P=5.164/<0.001,4.141/<0.001,12.354/<0.001).Serum FIZZ2 levels were positively correlated with PCT and CRP levels in patients with AECOPD and RF(r/P=0.452/<0.001,0.427/<0.001).High PCT,high FIZZ2 and high APACHEⅡscores were risk factors for poor prognosis in patients with AECOPD and RF[OR(95%CI)=1.680(1.111-2.541),1.921(1.147-3.217),2.547(1.278-5.078)].Serum FIZZ2,PCT,CRP and combined to predict the prognosis of patients with AECOPD combined RF AUC were 0.842,0.794,0.846,0.925,combined slightly better than their individual predictions(Z/P=3.465/0.001,2.399/0.016,2.194/0.028).Conclusion The increase of serum FIZZ2 level in patients with AECOPD combined with RF is associated with poor prognosis,and has a high value in predicting the prognosis of patients with AECOPD combined with RF.