摘要
目的:探究血清胱抑素C(CysC)和γ谷氨酰转移酶(GGT)水平联合动脉血气分析在评估慢性阻塞性肺疾病(COPD)严重程度中的应用价值。方法:纳入157例COPD患者为研究对象,根据病情严重程度将其分为轻度组(n=78)、中度组(n=49)和重度组(n=30)。收集患者的临床资料及入院时的实验室指标,分析COPD严重程度的影响因素及其与患者FEV1%pred的相关性,并分析影响因素对COPD严重程度的诊断价值。结果:三组患者血清CysC、GGT、动脉二氧化碳分压(PCO_(2))水平比较:重度组>中度组>轻度组(P<0.05);三组患者脉氧分压(PO_(2))、氧饱和度(SaO_(2))水平比较:重度组<中度组<轻度组(P<0.05)。高水平血清CysC、GGT、PCO_(2)及低水平PO_(2)、SaO_(2)均是导致COPD病情加重的危险因素(P<0.05)。患者血清CysC、GGT、PCO_(2)水平与FEV1%pred均呈负相关关系(P<0.05),PO_(2)、SaO_(2)水平均与FEV1%pred正相关(P<0.05)。血清CysC水平、血清GGT水平联合动脉血气分析预测COPD重度病情的曲线下面积(AUC)为0.922,相较于单一指标诊断,联合诊断效能较高(P<0.05)。结论:血清CysC、GGT水平及动脉血气分析与COPD患者病情严重程度存在密切联系,临床可通过检测血清CysC、GGT水平联合动脉血气分析指标评估COPD患者的病情严重程度。
Objective:To explore the application value of serum cystatin C(CysC)and gamma-glutamyl transferase(GGT)levels combined with arterial blood gas analysis on evaluating the severity of chronic obstructive pulmonary disease(COPD).Methods:157 COPD patients were selected and divided into mild group(n=78),moderate group(n=49)and severe group(n=30)according to the severity of the disease.Clinical data as well as laboratory indicators at admission were collected.The factors affecting the severity of COPD and their correlation with patients'FEV 1%pred were analyzed,and the diagnostic value of these factors on the severity of COPD were analyzed.Results:The levels of serum CysC,GGT and arterial partial pressure of carbon dioxide(PCO_(2))in the three groups were manifested as severe group>moderate group>mild group(P<0.05)while the arterial partial pressure of oxygen(PO 2)and oxygen saturation(SaO_(2))were represented as severe group<moderate group<mild group(P<0.05).Regression analysis showed that high levels of serum CysC,GGT and PCO_(2) and low levels of PO_(2) and SaO_(2) were risk factors of exacerbation of COPD(P<0.05).The levels of serum CysC,GGT and PCO_(2) were negatively correlated with FEV 1%pred(P<0.05),and the levels of PO_(2) and SaO_(2) were positively correlated with FEV 1%pred(P<0.05).The area under the curve(AUC)of serum CysC level,serum GGT level and arterial blood gas analysis to predict severe COPD disease was 0.922,compared with single indicator diagnosis,combined diagnosis had higher efficacy(P<0.05).Conclusion:Serum CysC,GGT and arterial blood gas analysis are closely related to the severity of COPD patients.Clinically,the severity of COPD can be evaluated by detecting serum CysC and GGT combined with arterial blood gas analysis.
作者
李成凤
LI Cheng-feng(Department of General Internal Medicine,Sichuan Friendship Hospital,Chengdu 610000,Sichuan,China)
出处
《川北医学院学报》
2025年第8期1044-1048,共5页
Journal of North Sichuan Medical College
基金
四川友谊医院临床研究项目(Tori-013)。
关键词
胱抑素C
Γ谷氨酰转移酶
动脉血气分析
慢性阻塞性肺疾病
严重程度
Cystatin C
Gamma-glutamyl transferase
Arterial blood gas analysis
Chronic obstructive pulmonary disease
Severity
