Impact of noninvasive positive pressure ventilation on the gene expression of ubiquitin system of skeletal muscle in patients with acute exacerbation of chronic obstructive pulmonary disease

Abstract

Objective: To investigate the change and relativity of noninvasive positive pressure ventilation (NIPPV) on the gene expression of ubiquitin system of skeletal muscle in patient with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

Methods: 80 patients with AECOPD were divided into two groups based on whether the NIPPV treatment was given or not, 38 cases in the study group and 42 in the control group. The blood gas analysis and pulmonary function were monitored and recorded before and 14 days after treatment. A skeletal muscle biopsy was performed 14 days after therapy. The mRNA expression of ribosomal protein S21 (RPS21) and ubiquitin in skeletal muscle cell were measured by RT-PCR.

Results: After 14 days treatment, the levels of PaCO₂, PaO₂, PH and FEV₁% in the NIPPV group improved much better than in the control group (p < .05). The gene expression of RPS21 and ubiquitin was obviously lower in the study group than in the control group (p < .05). The level of RPS21 was negatively related with PaO₂, PH and FEV₁%, and the level of ubiquitin was negatively related with PaO₂ and FEV₁% , but positively correlated with PaCO₂. The area under the ROC curves of RPS21, ubiquitin, PaCO₂ and FEV₁% were 0.771, 0.885, 0.821 and 0.734 respectively in the study group. The cut-off points were 103.978, 8.128, 45.350 and 51.350 respectively. The sensitivity evaluation of acid poisoning was 90.9%, and the specificities for each were 75%, 75%, 50% and 50%.

Conclusions: NIPPV is effective for AECOPD patients through the gene expression of ubiquitin system of skeletal muscle.