摘要
目的探讨不同程度慢性阻塞性肺疾病HIF-1α、NGAL水平与认知功能障碍的相关性。方法纳入2018年6月~2020年6月期间在本院呼吸科住院治疗的单纯慢阻肺患者80例(B组)、合并认知功能障碍患者78例,根据慢阻肺严重度将合并认知功能障碍患者分为2个亚组:稳定期25例(C组)、急性加重期53例(D组),另选择同期门诊健康体检者60例为对照(A组),比较各组一般资料、认知功能、肺功能、动脉血气相关指标及血清HIF-1α和NGAL水平;多因素logistic回归模型分析慢阻肺合并认知功能障碍的影响因素;采用Pearson相关分析法,分析认知功能与FEV 1、PaO_(2)、HIF-1α、NGAL的相关性;ROC曲线分析HIF-1α、NGAL对慢阻肺合并认知功能障碍的预测价值。结果与A组相比,B、C、D组FEV 1、FVC、FEV 1/FVC、PaO_(2)、SaO_(2)、MMSE均显著降低,而PaCO_(2)、NGAL和HIF-1α均显著升高(P<0.05);C、D组与B组相比上述指标均具有统计学差异(P<0.05);FEV 1<60%、PaO_(2)<70 mmHg、HIF-1α≥400 pg/mL和NGAL≥3.5μg/L为慢阻肺患者合并认知功能障碍的独立危险因素(P<0.05);MMSE评分与HIF-1α和NGAL呈显著负相关,与FEV 1和PaO_(2)呈显著正相关(P<0.05);HIF-1α和NGAL浓度分别为405.63 pg/mL和2.56μg/L时,联合预测慢阻肺合并认知功能障碍的曲线下面积为0.829(95%CI:0.816~0.882,P<0.001)。结论慢阻肺患者疾病严重程度能够影响患者的认知功能状态,慢阻肺合并认知功能障碍患者认知功能与血清HIF-1α和NGAL呈负相关,联合检测血清HIF-1α和NGAL水平能够为临床筛查和预防提供参考。
Objective To investigate the correlation between HIF-1αand NGAL levels and cognitive dysfunction in chronic obstructive pulmonary disease(COPD).Methods 80 patients with pure COPD(the group B)and 78 patients with combined cognitive dysfunction who were hospitalized in the respiratory department of our hospital from June 2018 to June 2020 were included.According to the severity of COPD,the patients with combined cognitive dysfunction were divided into two subgroups:25 patients at stable stage as the group C and 53 patients at acute exacerbation stage as the group D.In addition,60 healthy patients who underwent physical examination in outpatient department during the same period were selected as controls(the group A).General information,cognitive function,pulmonary function,arterial blood gas related indicators and serum HIF-1 and NGAL levels were compared among the groups.Multivariate logistic regression model was used to analyze the influencing factors of COPD with cognitive dysfunction.Pearson correlation analysis was used to analyze the correlation between cognitive function and FEV 1,PaO_(2),HIF-1 and NGAL.ROC curve analysis was used to predictive value of HIF-1 and NGAL for COPD with cognitive dysfunction.Results Compared with the group A,FEV 1,FVC,FEV 1/FVC,PaO_(2),SaO_(2) and MMSE in the group B,C and D were significantly decreased,while PaCO_(2),NGAL and HIF-1 were significantly increased(P<0.05).Compared with the group B,the above indicators in the group C and D were statistically different(P<0.05).FEV 1<60%,PaO_(2)<70 mmHg,HIF-1≥400 pg/mL,and NGAL≥3.5 g/L were independent risk factors for COPD patients with cognitive dysfunction(P<0.05).MMSE score was negatively correlated with HIF-1 and NGAL,and positively correlated with FEV 1 and PaO_(2)(P<0.05).When the concentrations of HIF-1 and NGAL were 405.63 pg/mL and 2.56 g/L,respectively,the area under the curve of combined prediction of COPD with cognitive dysfunction was 0.829(95%CI:0.816~0.882,P<0.001).Conclusion The severity of patients with COPD can affect their cognitive status,and the cognitive function of COPD patients combined with cognitive dysfunction is negatively correlated with the serum HIF-1 and NGAL levels.The combined detection of serum HIF-1 and NGAL levels can provide a reference for clinical screening and prevention.
作者
王亚楠
李娜
张甜甜
WANG Ya-nan;LI Na;ZHANG Tian-tian(Department of Respiratory Medicine,Xi′an International Medical Center Hospital,Xi′an,Shaanxi 710075,China)
出处
《临床肺科杂志》
2021年第9期1316-1321,共6页
Journal of Clinical Pulmonary Medicine
