[1]张榆铃,陈余思,孙 兰.AECOPD并发Ⅱ型呼吸衰竭患者血清PRDX6，ANXA1水平与病情程度及预后的关系研究[J].现代检验医学杂志,2025,40(06):97-103.[doi:10.3969/j.issn.1671-7414.2025.06.018]
　ZHANG Yuling,CHEN Yusi,SUN Lan.Relationship between Serum PRDX6 and ANXA1 Levels and Severity and Prognosis in Patients with AECOPD Complicated with Type II Respiratory Failure[J].Journal of Modern Laboratory Medicine,2025,40(06):97-103.[doi:10.3969/j.issn.1671-7414.2025.06.018]
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AECOPD并发Ⅱ型呼吸衰竭患者血清PRDX6，ANXA1水平与病情程度及预后的关系研究()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第40卷
期数:
2025年06期
页码:
97-103
栏目:
论著
出版日期:
2025-11-15

文章信息/Info

Title:
Relationship between Serum PRDX6 and ANXA1 Levels and Severity and Prognosis in Patients with AECOPD Complicated with Type II Respiratory Failure
文章编号:
1671-7414（2025）06-097-07
作者:
张榆铃，陈余思，孙 兰
攀枝花学院附属医院/攀枝花中西医结合医院呼吸与危重症医学科，四川攀枝花 617000
Author(s):
ZHANG Yuling，CHEN Yusi，SUN Lan
Department of Respiratory and Critical Care Medicine, Panzhihua University Affiliated Hospital/Panzhihua Integrated Traditional Chinese and Western Medicine Hospital, Sichuan Panzhihua 617000, China
关键词:
慢性阻塞性肺疾病急性加重期; Ⅱ型呼吸衰竭; 过氧化还原蛋白6; 膜联蛋白A1
分类号:
R563.8；R392.11
DOI:
10.3969/j.issn.1671-7414.2025.06.018
文献标志码:
A
摘要:
目的探讨慢性阻塞性肺疾病急性加重期（AECOPD）并发Ⅱ型呼吸衰竭患者血清过氧化还原蛋白6（PRDX6）和膜联蛋白A1（ANXA1）水平与病情程度及预后的关系。方法选取2021年12月～2023年12月攀枝花学院附属医院收治的AECOPD合并Ⅱ型呼吸衰竭患者257例（呼吸衰竭组），COPD稳定期患者130例（COPD稳定期组）和同期体检健康者130例（对照组）。根据氧合指数将AECOPD合并Ⅱ型呼吸衰竭患者分为轻度呼吸衰竭组（n=101）、中度呼吸衰竭组（n=80）、重度呼吸衰竭组（n=76），并根据28天预后分为死亡组（n=62）和存活组（n=195）。采用酶联免疫吸附法（ELISA）检测血清PRDX6，ANXA1水平。通过Spearman相关系数分析血清PRDX6，ANXA1水平与AECOPD合并Ⅱ型呼吸衰竭患者氧合指数的相关性。多因素Logistic回归模型分析AECOPD合并Ⅱ型呼吸衰竭患者不良预后的影响因素，并绘制受试者工作特征（ROC）曲线评价血清PRDX6，ANXA1对其的预测价值。结果呼吸衰竭组血清PRDX6水平（41.54±4.28pg/ml）低于COPD稳定期组（61.38±4.94pg/ml）和对照组（80.65±8.93pg/ml），ANXA1水平（3.35±0.69μg/L）高于COPD稳定期组（2.13±0.61μg/L）和对照组（1.03±0.14μg/L），差异具有统计学意义（t=-33.894～21.727，均P<0.001）。重度呼吸衰竭组血清PRDX6水平（34.54±5.05pg/ml）低于中度呼吸衰竭组（43.90±4.72pg/ml）和轻度呼吸衰竭组（54.28±6.34pg/ml），ANXA1水平（3.94±0.43μg/L)高于中度呼吸衰竭组(3.57±0.46μg/L)和轻度呼吸衰竭组(2.70±0.43μg/L），差异具有统计学意义（t=-19.018～22.338，均P<0.001）。AECOPD合并Ⅱ型呼吸衰竭患者氧和指数与血清PRDX6呈正相关（r=0.815，P<0.001），ANXA1水平呈负相关（r=-0.781，P<0.001）。随访28天，257例AECOPD合并Ⅱ型呼吸衰竭患者死亡率为24.12%（62/257）。第1秒用力呼气容积（FEV1）占预计值百分比增加、氧合指数增加、PRDX6升高为AECOPD合并Ⅱ型呼吸衰竭患者不良预后的独立保护因素（Waldχ2=-0.154，-0.014，-0.173，均P<0.05），ANXA1升高为独立危险因素（Waldχ2=0.250，P<0.05）。血清PRDX6，ANXA1联合预测AECOPD合并Ⅱ型呼吸衰竭患者不良预后的曲线下面积为0.906，大于两指标单独预测的0.788，0.781，差异具有统计学意义（Z=4.243，4.224，均P<0.001）。结论血清PRDX6水平降低和ANXA1水平升高与AECOPD合并Ⅱ型呼吸衰竭患者病情加重和预后不良有关，血清PRDX6，ANXA1联合预测AECOPD合并Ⅱ型呼吸衰竭患者预后的价值较高。
Abstract:
Objective To investigate the relationship between serum peroxiredoxin 6 (PRDX6) and annexin A1 (ANXA1) levels and the severity and prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) compli-cated with type II respiratory failure. Methods A total of 257 patients with AECOPD complicated with type II respiratory failure (respiratory failure group), 130 patients with stable COPD (stable COPD group) and 130 healthy subjects (control group) were selected from the Panzhihua University Affiliated Hospital from December 2021 to December 2023.According to the oxygenation index, AECOPD patients with type II respiratory failure were divided into mild respiratory failure group (n=101), moderate respi-ratory failure group (n=80) and severe respiratory failure group (n=76). According to the 28-day prognosis, they were divided into death group (n=62) and survival group (n=195).Serum PRDX6 and ANXA1 levels were detected by enzyme-linked immu-nosorbent assay(ELISA). The correlation between serum PRDX6, ANXA1 levels and oxygenation index in AECOPD patients with type II respiratory failure was analyzed by Spearman correlation coefficient. Multivariate Logistic regression model was used to analyze the influencing factors of poor prognosis in patients with AECOPD complicated with type II respiratory fail-ure, and receiver iperating characteristic (ROC) curve was drawn to evaluate the predictive value of serum PRDX6 and ANXA1. Results The serum PRDX6 level in the respiratory failure group (41.54±4.28 pg/ml) was lower than that in the stable COPD group (61.38±4.94 pg/ml) and the control group (80.65±8.93 pg/ml), and the ANXA1 level (3.35±0.69 μg/L) was higher than that in the stable COPD group (2.13±0.61 μg/L) and the control group (1.03±0.14 μg/L), the differences were statistically sig-nificant (t=-33.894 ~ 21.727, all P< 0.001).The serum level of PRDX6 in severe respiratory failure group (34.54±5.05 pg/ml) was lower than that in moderate respiratory failure group (43.90±4.72 pg/ml) and mild respiratory failure group (54.28 ± 6.34 pg/ml), the serum level of ANXA1 in severe respiratory failure group (3.94±0.43 μg/L) was higher than that in moderate respi-ratory failure group (3.57±0.46 μg/L) and mild respiratory failure group (2.70±0.43 μg/L), the differences were statistically sig-nificant (t=-19.018 ~ 22.338, all P< 0.001).Oxygen index was positively correlated with serum PRDX6 (r= 0.815, P< 0.001) and negatively correlated with ANXA1 (r=-0.781, P<0.001) in AECOPD patients with type II respiratory failure.The mortality rate of 257 AECOPD patients with type II respiratory failure was 24.12 % (62/257 ) after 28 days of follow-up. Increase forced expi-ratory volume in the first second （FEV1） as a percentage of the predicted value , increased oxygenation index and increased PRDX6 were independent protective factors for the poor prognosis of AECOPD patients with type II respiratory failure(Wald χ2=-0.154,-0.014,-0.173, all P<0.05), increased ANXA1 was an independent risk factor (Wald χ2=0.250, P<0.05).The area un-der the curve of serum PRDX6 and ANXA1 combined to predict the poor prognosis of AECOPD patients with type II respiratory failure was 0.906, which was greater than 0.788 and 0.781 predicted by the two indicators alone, and the differences were statisti-cally significant (Z=4.243, 4.224, all P< 0.001). Conclusion The decrease of serum PRDX6 level and the increase of ANXA1 level are related to the aggravation and poor prognosis of AECOPD patients with type II respiratory failure. The value of serum PRDX6 combined with ANXA1 in predicting the prognosis of AECOPD patients with type II respiratory failure is high.

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备注/Memo

备注/Memo:
基金项目：四川省医学会科研课题（编号：S20085）。
作者简介：张榆铃（1986-）女，本科，副主任医师，研究方向：呼吸重症，E-mail：z15881282766@163.com。
通讯作者：孙兰（1994-），研究方向：哮喘、慢阻肺，E-mail：sunlan0213@126.com。
更新日期/Last Update: 2025-11-15