摘要
目的:探究外周血趋化因子配体-18(CCL18)、可溶性髓样细胞触发受体-1(sTREM-1)、超敏C-反应蛋白/白蛋白(hs-CRP/Alb)联合检测对慢性阻塞性肺疾病急性加重(AECOPD)患者预后的预测价值。方法:选取286例AECOPD患者为研究组,根据病情分级不同将患者分为Ⅰ级组(n=91)、Ⅱ级组(n=122)和Ⅲ级组(n=73);根据预后不同将患者分为预后不良组(n=63)和预后良好组(n=223)。另选取200名同期健康体检志愿者为对照组。比较研究组和对照组间、不同病情组患者间、不同预后患者间外周血CCL18、sTREM-1、hs-CRP/Alb水平差异,并分析其与AECOPD患者病情分级的相关性及对预后的预测价值。结果:研究组患者外周血CCL18、sTREM-1、hs-CRP/白蛋白(Alb)水平高于对照组(P<0.05);不同病情分级患者外周血CCL18、sTREM-1、hs-CRP/Alb水平比较:I级组<Ⅱ组<Ⅲ级组(P<0.05);预后不良组患者外周血CCL18、sTREM-1、hs-CRP/Alb水平均高于预后良好组(P<0.05)。相关性分析显示,外周血CCL18、sTREM-1、hs-CRP/Alb水平与AECOPD患者病情正相关(P<0.05)。受试者工作特征(ROC)曲线分析显示,CCL18、sTREM-1、hs-CRP/Alb单独及联合预测AECOPD患者预后的敏感度分别为71.43%、71.43%、76.19%、84.13%,特异度分别为70.40%、72.20%、73.99%、68.16%,曲线下面积(AUC)分别为0.791、0.777、0.821、0.935,均有预测价值(P<0.05),且联合预测的价值更高(P<0.05)。结论:AECOPD患者中血清CCL18、sTREM-1、hs-CRP/Alb水平上调,且与病情相关,可用于预后评估。
Objective:To explore the predictive value of combined detection of peripheral blood chemokine ligand-18(CCL18),soluble triggering receptor expressed on myeloid cells-1(sTREM-1) and high-sensitivity C-reactive protein/albumin(hs-CRP/Alb) on the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:The data of 286 patients with AECOPD were retrospectively analyzed and the patients were enrolled as study group,they were classified into grade Ⅰ(n=91),Ⅱ(n=122),and Ⅲ(n=73) groups by disease severity,and divided into poor prognosis group(n=63) and good prognosis group(n=223) according to the prognosis,and 200 healthy subjects with physical examination were selected as control group.The levels of CCL18,sTREM-1 and hs-CRP/Alb in peripheral blood were compared between the two groups.The levels of peripheral blood CCL18,sTREM-1 and hs-CRP/Alb were compared among patients with different disease severities.To analyze the correlation between levels of peripheral blood CCL18,sTREM-1 and hs-CRP/Alb and disease condition.To analyze the predictive value of peripheral blood CCL18,sTREM-1 and hs-CRP/Alb levels on the prognosis of AECOPD patients.Results:The levels of peripheral blood CCL18,sTREM-1 and hs-CRP/Alb in study group were higher than those in control group(P<0.05).The levels of CCL18,sTREM-1 and hs-CRP/Alb in peripheral blood of patients with AECOPD grade I were lower than those of patients with grade Ⅱ or Ⅲ AECOPD(P<0.05),and the above levels of patients with AECOPD grade Ⅱ were lower than those of patients with AECOPD grade Ⅲ patients(P<0.05).The levels of CCL18,sTREM-1 and hs-CRP/Alb in peripheral blood were higher in poor prognosis group than those in good prognosis group(P<0.05).Spearman correlation coefficient analysis showed that the levels of peripheral blood CCL18,sTREM-1 and hs-CRP/Alb were positively correlated with disease condition of AECOPD patients(P<0.05).Receiver operating characteristic curve curve analysis suggested that the sensitivities of CCL18,sTREM-1,hs-CRP/Alb alone and in combination in predicting the prognosis of AECOPD patients were 71.43%,71.43%,76.19% and 84.13% respectively,and the specificities were 70.40%,72.20%,73.99% and 68.16%,and the AUCs were 0.791,0.777,0.821 and 0.935 respectively.The combined diagnostic value was higher(P<0.05).Conclusion:The levels of serum CCL18,sTREM-1 and hs-CRP/Alb in patients with AECOPD are up-regulated,and are correlated with disease condition,and they can be used for prognosis evaluation.
作者
陈美凤
马小军
朱健荣
乔莹莹
范晓枝
郭淑明
CHEN Mei-feng;MA Xiao-jun;ZHU Jian-rong;QIAO Ying-ying;FAN Xiao-zhi;GUO Shu-ming(Linfen Central Hospital,Linfen 041000,Shanxi,China)
出处
《川北医学院学报》
2025年第3期314-318,共5页
Journal of North Sichuan Medical College
基金
山西省卫生健康委科研项目(2021157)。
关键词
慢性阻塞性肺疾病急性加重
趋化因子配体-18
可溶性髓样细胞触发受体-1
超敏C-反应蛋白
白蛋白
预后
Acute exacerbation of chronic obstructive pulmonary disease
Chemokine ligand-18
Soluble triggering receptor expressed on myeloid cells-1
High-sensitivity C-reactive protein
Albumin
Prognosis
