Correlation and clinical significance of serum ChE and PA levels with APACHE Ⅱ scores in patients with COPD complicated with respiratory failure
Objective To investigate the correlation and clinical significance of serum cholinesterase(ChE)and prealbumin(PA)levels with acute physiology and chronic health status evaluation Ⅱ(APACHE Ⅱ)score in patients with COPD complicated with respiratory failure.Methods A total of 196 COPD patients admitted to Yucheng People's Hospital from May 1,2020,to October 31,2022,were selected as the study subjects.Patients were divided into a combined group(n=103)and a non-combined group(n=93)based on the presence or absence of respiratory failure.The COPD patients with respiratory failure were further divided into deceased(n=27)and surviving(n=76)subgroups based on their 28-day hospital survival.The serum ChE,PA levels,APACHE Ⅱ scores,and blood gas analysis indicators[arterial oxygen tension(PaO2),arterial carbon dioxide tension(PaCO2)]were compared between the two groups.The serum ChE and PA levels were compared in the deceased and surviving subgroups.The correlation between serum ChE and PA levels,APACHE Ⅱ scores,and blood gas analysis indicators was analyzed.Logistic regression analysis was used to iden-tify factors affecting the prognosis of COPD patients with respiratory failure.The predictive value of serum ΔChE andΔPA levels in the prognosis of COPD patients with respiratory failure was analyzed using receiver operating characteristics(ROC)curves.Results At admission,the levels of ChE(3 058.65±418.69)U/L,PA(129.58±16.78)mg/L,PaO2(44.58±5.73)mmHg in the combined group were lower than those in the non-combined group(5 843.26±489.17)U/L,(204.34±21.56)mg/L,(69.17±4.49)mmHg.The scores of PaCO2(62.49±4.78)mmHg and APACHE Ⅱ(34.68± 4.15)were higher than those of the non-combined group(37.44±3.18)mmHg and(21.59±3.67),with statistically significant differences(t values were 42.928,27.227,33.192,42.714,23.189,all P＜0.001);After 7 days of treat-ment,the levels of ChE/L and PA in serum of deceased patients(3 464.29±358.43)U/L and PA(140.08± 15.76)mg/L were lower than those of surviving patients(5 246.76±322.84)U/L and(189.36±16.53)mg/L(F val-ues were 22.449,18.762,all P＜0.001).Serum ChE and PA levels at admission were positively correlated with PaO2,but negatively correlated with PaCO2 and APACHE Ⅱ scores(P＜0.05).Logistic regression analysis showed that serumΔChE(＞1 720.86 U/L)and ΔPA(＞46.86 mg/L)levels were protective factors for prognosis of COPD patients with respiratory failure(P＜0.05).ROC curve showed that the AUC of serum ΔChE and ΔPA combined to predict the prog-nosis of COPD patients with respiratory failure was 0.836,and the best sensitivity and specificity were 96.30％and 71.05％,respectively(P＜0.05).Conclusions Serum ChE and PA levels are low in COPD patients with respiratory fail-ure.Dynamic monitoring of serum level changes can understand the severity of patients'disease,and the combined appli-cation can effectively predict the prognosis,which can provide a basis for the formulation of early clinical prevention and treatment measures.
chronic obstructive pulmonary diseasrespiratory failureacute physiology and chronic health status evaluation Ⅱcholinesteraseprealbumin
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