白介素-6、总胆固醇与II型呼吸衰竭患者营养状态的相关性分析

敏洁 黄; 曹磊; 李杰; 陈香; 刘澄英; 陶俊

doi:10.62177/fcdt.v2i2.1295

Authors

敏洁黄江阴市人民医院
曹磊南通大学附属江阴人民医院呼吸与危重症医学科
李杰南通大学附属江阴人民医院呼吸与危重症医学科
陈香南通大学附属江阴人民医院呼吸与危重症医学科
刘澄英南通大学附属江阴人民医院呼吸与危重症医学科
陶俊南通大学附属江阴人民医院呼吸与危重症医学科

DOI:

https://doi.org/10.62177/fcdt.v2i2.1295

Keywords:

慢性阻塞性肺疾病急性加重, Ⅱ型呼吸衰竭, 营养不良, 白细胞介素-6, 总胆固醇

Abstract

目的：探讨白细胞介素-6（Interleukin-6, IL-6）、总胆固醇（Total Cholesterol, TC）水平在不同营养状态的老年慢性阻塞性肺疾病急性加重（Acute Exacerbation of Chronic Obstructive Pulmonary Disease, AECOPD）伴Ⅱ型呼吸衰竭（Type II Respiratory Failure, RF）患者中的表达差异及其与营养状态的临床相关性。方法：回顾性分析2022年1月至2024年1月期间，江阴市人民医院收治的109例老年AECOPD伴Ⅱ型RF患者的临床资料。根据入院时血清白蛋白（Albumin, ALB）水平，将患者分为营养不良组（ALB < 35 g/L, n=39）和非营养不良组（ALB ≥ 35 g/L, n=70）。比较两组患者的一般临床资料、IL-6、TC及其他实验室指标的差异。采用多因素Logitic回归分析影响患者营养状态的独立危险因素。通过受试者工作特征（Receiver Operating Characteristic, ROC）曲线评估年龄、IL-6、TC对营养不良的预测价值。结果：营养不良组患者的年龄显著高于非营养不良组[79 (73, 82）岁 vs 73.5 (70, 77）岁， P=0.008]，IL-6水平显著升高[31.33 (7.40, 59.29) pg/mL vs 15.62 (6.91, 32.57) pg/mL, P=0.020]，TC水平显著降低[3.43 (2.78, 4.15) mmol/L vs 4.08 (3.52, 4.50) mmol/L, P=0.002]。多因素Logistic回归分析显示，年龄（OR=0.913, 95%CI: 0.840~0.992, P=0.032）、IL-6（OR=0.978, 95%CI: 0.961~0.995, P=0.013）是营养不良的独立危险因素，而TC（OR=4.613, 95%CI: 1.975~10.776, P=0.000）是营养良好的保护因素。年龄、IL-6、TC预测营养不良的ROC曲线下面积（Area Under Curve, AUC）分别为0.653（95%CI: 0.542~0.763, P=0.008）、0.634（95%CI: 0.518~0.751 P=0.020）、0.676（95%CI: 0.588~0.764, P=0.002）。结论：老年AECOPD伴Ⅱ型RF患者中，高龄、高IL-6水平和低TC水平与营养不良密切相关，是发生营养不良的独立危险因素。IL-6和TC可作为评估此类患者营养风险的潜在生物标志物。

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