检验医学与临床2025，Vol.22Issue(9)：1153-1158,1164,7.DOI:10.3969/j.issn.1672-9455.2025.09.001
老年AECOPD合并Ⅱ型呼吸衰竭患者血清miR-223、miR-130a水平及对预后的影响
Serum miR-223 and miR-130a levels in elderly patients with AECOPD complicating type Ⅱ respiratory failure and their influence on prognosis
摘要
Abstract
Objective To investigate the serum microRNA-223(miR-223)and microRNA-130a(miR-130a)levels in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicating type Ⅱ respiratory failure(Ⅱ-RF)and their influence on the prognosis.Methods A total of 155 elderly patients with AECOPD complicating Ⅱ-RF admitted and treated in Baoji Municipal People's Hospital from May 2022 to May 2023 were selected as the research subjects,given the conventional symptomatic treat-ment after admission and conducted the 1 year follow up after treatment for performing the prognosis statis-tics.The patients were divided into the poor prognosis group and the good prognosis group according to the prognosis.The general data and serum miR-223 and miR-130a levels at admission were compared between the two groups.The correlations between serum miR-223 and miR-130a levels with the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)scores and pulmonary function indicators[total lung capacity(TLC),forced expiratory volume in one second(FEV1),ratio of FEV1 to forced vital capacity(FEV1/FVC)]were analyzed.The multivariate Logistic regression was used to analyze the influencing factors of poor progno-sis in elderly patients with AECOPD complicating Ⅱ-RF.The receiver operating characteristic(ROC)curve was drawn to analyze the value of serum miR-223 and miR-130a in predicting the poor prognosis in elderly pa-tients with AECOPD complicating Ⅱ-RF.Results During the follow-up period,5 cases lost to follow-up,and 150 cases finally entered in the result analysis.There were 44 cases in the poor prognosis group and 106 cases in the good prognosis group,and the incidence rate of poor prognosis was 29.33％.The age at admission,pro-portion of smoking history,APACHE Ⅱ score and the levels of serum miR-223 and miR-130a in the poor prognosis group were higher than those in the good prognosis group(P＜0.05),the duration of non-invasive assisted ventilation treatment was longer than that in the good prognosis group(P＜0.05),and TLC,FEV1 and FEV1/FVC were lower than those in the good prognosis group(P＜0.05).The results of Pearson corre-lation analysis showed that the serum miR-223 and miR-130a levels in elderly patients with AECOPD compli-cating Ⅱ-RF were positively correlated with the APACHE Ⅱ score(P＜0.05),and negatively correlated with TLC,FEV1 and FEV1/FVC(P＜0.05).The multivariate Logistic regression analysis results showed that in-creased age,smoking history,increased APACHE Ⅱ score,increased serum miR-223 level and increased serum miR-130a level were the independent risk factors for the poor prognosis in elderly patients with AECOPD complicating Ⅱ-RF(P＜0.05).After correcting for age,smoking history and APACHE Ⅱ score,the results of multivariate Logistic regression analysis showed that the increased serum miR-223 level and increased ser-um miR-130a level were still the independent risk factors for the poor prognosis in elderly patients with AE-COPD complicating Ⅱ-RF(P＜0.05).The results of ROC curve analysis showed that the areas under the curve(AUC)of serum miR-223,miR-130a and their combination in predicting the poor prognosis in elderly patients with AECOPD complicating Ⅱ-RF were 0.761,0.775 and 0.863 respectively.AUC of the combined prediction was greater than that of serum miR-223 and miR-130a alone(Z=0.196,0.188,P＜0.05).Conclu-sion The increased levels of serum miR-223 and miR-130a are the independent risk factors for the poor prog-nosis in elderly patients with AECOPD complicating Ⅱ-RF.Serum miR-223 and miR-130a has certain value in predicting the prognosis and outcome of the patients.关键词
慢性阻塞性肺疾病急性加重期/Ⅱ型呼吸衰竭/微小RNA-223/微小RNA-130a/预后/预测Key words
acute exacerbation of chronic obstructive pulmonary disease/type 2 respiratory failure/microRNA-223/microRNA-130a/prognosis/prediction分类
临床医学引用本文复制引用
党苗苗,韩朋飞,任海锋..老年AECOPD合并Ⅱ型呼吸衰竭患者血清miR-223、miR-130a水平及对预后的影响[J].检验医学与临床,2025,22(9):1153-1158,1164,7.基金项目
陕西省重点研发计划项目(2022SF-570). （2022SF-570）
