老年慢性阻塞性肺疾病急性加重期患者早期肾损伤的相关性分析。
Correlation Analysis of Early Renal Injury in Elderly Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease.
机构信息
Department of Internal Medicine, The Second Hospital of Beijing, Beijing, 100031, People's Republic of China.
出版信息
Int J Chron Obstruct Pulmon Dis. 2022 Sep 6;17:2109-2115. doi: 10.2147/COPD.S377847. eCollection 2022.
OBJECTIVE
To investigate the correlation between serum cystatin C (Cys-C) and beta-2 (β2) microglobulin (β2-MG) levels and renal injury in elderly patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) with a view to detecting renal injury in its early stages.
METHODS
A total of 106 patients with AECOPD were enrolled and divided into three groups according to their oxygen partial pressure (PO) levels: severe hypoxia group, moderate hypoxia group, and mild hypoxia group. Another 60 healthy subjects were selected as the control group. General clinical data were collected from all the study subjects, along with measurements of arterial blood gas, Cys-C, β2-MG, serum creatinine (Scr), urea nitrogen (BUN), partial pressure of carbon dioxide (PCO), and high-sensitivity C-reactive protein (hs-CRP).
RESULTS
The levels of hs-CRP, Cys-C, β2-MG, Scr, and BUN were highest in the severe hypoxia group, followed by the moderate hypoxia group, then the mild hypoxia group, and lowest in the control group. The differences between the groups were statistically significant for these indicators (P < 0.05). Apart from in the cases of Scr and BUN, there were no statistically significant differences between the mild group and the control group (P > 0.05). The levels of Cys-C and β2-MG were positively correlated with the levels of hs-CRP, PCO, Scr, and BUN and negatively correlated with PO levels. hs-CRP and PO were high-risk factors influencing Cys-C levels, and β2-MG was a risk factor influencing Cys-C levels. The level of PO was a high-risk factor influencing β2-MG levels, and PCO and Cys-C were risk factors influencing β2-MG levels.
CONCLUSION
Renal injury was found to be present in patients with AECOPD and worsened with increasing degrees of hypoxia. Hypoxia and inflammation might be risk factors for renal injury in patients with AECOPD, Cys-C and β2-MG could be sensitive indicators for the early detection of renal injury.
目的
探讨血清胱抑素 C（Cys-C）和β2 微球蛋白（β2-MG）水平与老年慢性阻塞性肺疾病急性加重期（AECOPD）患者肾损伤的相关性，以期早期发现肾损伤。
方法
选择 106 例 AECOPD 患者，根据氧分压（PO）水平分为重度缺氧组、中度缺氧组和轻度缺氧组，另选 60 例健康体检者作为对照组。收集所有研究对象的一般临床资料，检测动脉血气、Cys-C、β2-MG、血肌酐（Scr）、尿素氮（BUN）、二氧化碳分压（PCO）和高敏 C 反应蛋白（hs-CRP）。
结果
hs-CRP、Cys-C、β2-MG、Scr 和 BUN 水平在重度缺氧组最高，其次是中度缺氧组、轻度缺氧组，对照组最低，组间比较差异有统计学意义（P<0.05）。除 Scr 和 BUN 外，轻度组与对照组比较差异无统计学意义（P>0.05）。Cys-C 和 β2-MG 水平与 hs-CRP、PCO、Scr 和 BUN 呈正相关，与 PO 呈负相关。hs-CRP 和 PO 是影响 Cys-C 水平的高危因素，β2-MG 是影响 Cys-C 水平的危险因素。PO 是影响 β2-MG 水平的高危因素，PCO 和 Cys-C 是影响 β2-MG 水平的危险因素。
结论
AECOPD 患者存在肾损伤，且随缺氧程度加重而加重。缺氧和炎症可能是 AECOPD 患者肾损伤的危险因素，Cys-C 和 β2-MG 可能是肾损伤早期检测的敏感指标。
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