Abstract 【Objective】To analyze the predictive value of serum monocyte chemoattractant protein-1 (MCP-1) and high mobility group protein 1 (HMGB1) in the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with ventilator-associated pneumonia. 【Methods】A total of 83 patients with AECOPD complicated with ventilator-associated pneumonia admitted to the first affiliated hospital of Anhui medical university from August 2018 to June 2021 were selected as the research objects. Basic data of all patients were collected and serological indexes [MCP-1 and HMGB1] of patients were detected within 24h. Patients were divided into the survival group and the death group according to the survival status within 1 month of follow-up. Logistic multivariate regression analysis was used to explore the relevant factors affecting the clinical prognosis of patients with AECOPD complicated with ventilator-associated pneumonia. The receiver operating characteristic curve (ROC) was used to determine the level of serum MCP-1 and HMGB1 for predicting clinical effects and prognosis of AECOPD with ventilator-associated pneumonia. 【Results】Among the 83 patients with AECOPD complicated with ventilator-associated pneumonia in this study, 19 patients died of ineffective treatment (he death group), accounting for 22.89% (19/83) and 64 surviving patients (the survival group), accounting for 77.11%. The acute physiological and chronic health status (APACHEⅡ) score> 20 points, the organ failure (SOFA) score> 6 points, the proportion of mechanical ventilation time ≥ 72 h and the serum MCP-1 and HMGB1 levels in patients of the death group were higher than those in the survival group. The difference was statistically significant (P<0.05). Logistic multivariate regression analysis showed that APACHEⅡ score>20 points, SOFA score>6 points, mechanical ventilation time ≥72 h, higher serum MCP-1 and HMGB1 expression levels were risk factors for death in patients with AECOPD complicated with ventilator-associated pneumonia (P<0.05). ROC analysis showed that the area under the curve (AUC) of single and combined serum MCP-1 and HMGB1 levels for clinical prognosis of patients with AECOPD complicated with ventilator-associated pneumonia were 0.774, 0.743 and 0.848 respectively. The efficacy of serum MCP-1 and HMGB1 levels alone in predicting the clinical prognosis of patients with AECOPD complicated with ventilator-associated pneumonia was lower than that of the combination of the two (P<0.05). 【Conclusion】Patients with AECOPD complicated with ventilator-associated pneumonia with high APACHEⅡ and SOFA scores plus longer mechanical ventilation are more likely to have a prognosis of death. Serum MCP-1 and HMGB1 have certain clinical predictive value for the prognosis of patients with AECOPD complicated with ventilator-associated pneumonia.
DING Ying-nan,YOU Qing-hai. Predictive Value of Serum MCP-1 and HMGB1 in AECOPD Complicated with Ventilator-associated Pneumonia[J]. JOURNAL OF CLINICAL RESEARCH, 2021, 38(11): 1639-1642.
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