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目的:探究VEGF与COPD急性加重期并发呼吸衰竭患者预后的相关性。方法:选取2014年3月至2015年6月来我院就诊的COPD急性加重期并发呼吸衰竭的患者70例为研究对象,将在随访期存活的52例患者作为存活组,死亡的18例患者作为死亡组。患者入院后24 h内收集完基本资料,均给予经验性广谱抗生素、吸氧和化痰剂、支气管扩张剂以及有效的无创或有创通气,若情况得不到有效控制,必要时转入ICU进行治疗。测定血清VEGF水平、hs-CRP含量、FIB、PCT、WBC,FEV1/Pred%、FEV1/FVC%、Pa CO2、Pa O2/Fi O2,并进行APACHEⅢ评分。结果:两组患者在性别、BMI方面没有差异,但在年龄、病程和吸烟指数方面存在明显的差异,且具有统计学意义(P<0.05)。死亡组患者的VEGF、hs-CRP、PCT、FEV1/Pred%、FEV1/FVC%和Pa O2/Fi O2均明显低于存活组,WBC、Pa CO2和APACHEⅢ明显高于存活组,差异具有统计学意义(P<0.05),FIB在两组之间差异无统计学意义(P>0.05)。血清VEGF与BMI、病程、FEV1/Pred%、FEV1/FVC%及APACHEⅢ评分呈正相关,与Pa CO2呈负相关,差异具有统计学意义(P<0.05),与年龄、病程、吸烟指数、氧合指数、hs-CRP和PCT不具有直线相关性。结论:血清VEGF作为检测COPD急性加重期并发呼吸衰竭患者炎症程度的相关因子之一,可成为评估患者病情预后的重要血清生物学标志物。
Objective: To investigate the relationship between VEGF and the prognosis of COPD patients with acute exacerbation of respiratory failure. Methods: Seventy patients with acute exacerbation of COPD who visited our hospital from March 2014 to June 2015 were enrolled in this study. Totally 52 patients survived during the follow-up period as the survival group and 18 patients died As a death group. Patients within 24 h after admission collected basic information, are given empirical broad-spectrum antibiotics, oxygen and phlegm, bronchodilators and effective noninvasive or invasive ventilation, if the situation can not be effectively controlled, if necessary, transferred ICU for treatment. Serum levels of VEGF, hs-CRP, FIB, PCT, WBC, FEV1 / Pred%, FEV1 / FVC%, PaCO2, Pa O2 / Fi O2 were measured and APACHE III scores were assessed. Results: There were no differences in gender and BMI between the two groups, but there were significant differences in age, disease course and smoking index between the two groups (P <0.05). The levels of VEGF, hs-CRP, PCT, FEV1 / Pred%, FEV1 / FVC% and Pa O2 / Fi O2 in the death group were significantly lower than those in the survival group, WBC, PaCO2 and APACHEIII were significantly higher than those in the survival group (P <0.05). There was no significant difference in FIB between the two groups (P> 0.05). Serum VEGF was positively correlated with BMI, course of disease, FEV1 / Pred%, FEV1 / FVC% and APACHEⅢ scores, but negatively correlated with PaCO2 (P <0.05) Index, hs-CRP and PCT do not have a linear correlation. Conclusion: Serum VEGF is one of the relevant factors for detecting the degree of inflammation in COPD patients with acute exacerbation of respiratory failure, which may be an important serum biomarker for evaluating the prognosis of patients.